{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T13:59:12Z","timestamp":1785419952323,"version":"3.56.0"},"reference-count":355,"publisher":"American Society for Microbiology","issue":"2","license":[{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/doi.org\/10.1128\/ASMCopyrightv2"},{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Clin Microbiol Rev"],"published-print":{"date-parts":[[2026,6,11]]},"abstract":"<jats:title>SUMMARY<\/jats:title>\n                  <jats:p>\n                    Jorge Lobo\u2019s disease (JLD) is a chronic cutaneous and subcutaneous mycosis endemic to the Amazon Basin and tropical rainforests of Latin America. Despite more than a century of study, the disease remains underrecognized, poses significant diagnostic challenges, and is often therapeutically refractory. Here, we synthesize historical, clinical, and ecoepidemiological evidence; provide a practical diagnostic approach; and highlight unresolved questions. Clinically, JLD presents as slowly progressive keloid-like nodules and plaques on exposed areas. Diagnosis relies on direct microscopy and histopathology showing chains of thick-walled yeast-like cells connected by narrow-neck budding; culture is not feasible, and molecular assays are rarely available outside reference centers. We contrast JLD with key mimickers (cutaneous leishmaniasis, chromoblastomycosis, leprosy, atypical mycobacterioses, and non-infectious lesions such as keloid scars) and summarize current management options, emphasizing when surgery alone suffices and when prolonged azole therapy should be considered. From an ecoepidemiological perspective, historical settlement patterns, occupational exposures, and environmental disturbance in humid forest biomes appear to have amplified human contact with putative environmental reservoirs. New phylogenomic data position\n                    <jats:italic toggle=\"yes\">Paracoccidioides lobogeorgii<\/jats:italic>\n                    as an early-diverging lineage within\n                    <jats:italic toggle=\"yes\">Paracoccidioides<\/jats:italic>\n                    , refining prior MLST-based inferences. We outline practical surveillance steps to address under-ascertainment, standardized case definitions, sentinel reporting, and laboratory quality assurance and propose research priorities spanning environmental detection, host\u2013pathogen interactions, and therapeutic evaluation. We contextualize the disease within broader frameworks of fungal emergence, structural neglect, and environmental disruption, arguing that revisiting JLD is not merely retrospective but a necessary scientific and ethical priority.\n                  <\/jats:p>","DOI":"10.1128\/cmr.00302-25","type":"journal-article","created":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T13:00:41Z","timestamp":1778763641000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":0,"title":["Revisiting the natural history of Jorge Lobo\u2019s disease: a mycological enigma spanning unresolved taxonomy, uncertain transmission, and inadequate therapy"],"prefix":"10.1128","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1763-3464","authenticated-orcid":true,"given":"Marcus de 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Instituto Socioambiental, S\u00e3o Paulo."},{"key":"e_1_3_2_38_2","volume-title":"Contribui\u00e7\u00e3o para o estudo da epidemiologia da blastomicose queloidiforme de Jorge L\u00f4bo","author":"Machado P","year":"1968","unstructured":"Machado P. 1968 Contribui\u00e7\u00e3o para o estudo da epidemiologia da blastomicose queloidiforme de Jorge L\u00f4bo"},{"key":"e_1_3_2_39_2","first-page":"10","article-title":"Os fungos da doen\u00e7a de Adolfo Lutz, da doen\u00e7a de Jorge L\u00f4bo e da blastomicose dos \u00edndios do Alto Xingu (Brasil Central \u2014 Estado do Mato Grosso)","volume":"14","author":"Pereira Filho MJ","year":"1957","unstructured":"Pereira Filho MJ. 1957. Os fungos da doen\u00e7a de Adolfo Lutz, da doen\u00e7a de Jorge L\u00f4bo e da blastomicose dos \u00edndios do Alto Xingu (Brasil Central \u2014 Estado do Mato Grosso). 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