{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T06:15:45Z","timestamp":1790230545029,"version":"4.1.0"},"update-to":[{"DOI":"10.1371\/journal.pntd.0013499","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T00:00:00Z","timestamp":1757376000000}}],"reference-count":16,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T00:00:00Z","timestamp":1756944000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Chromoblastomycosis and phaeohyphomycotic abscesses are infections of the skin and subcutaneous tissues caused by dematiaceous fungi; more rarely, phaeohyphomycotic brain abscesses can occur. The epidemiology and clinical outcomes of chromoblastomycosis and phaeohyphomycotic abscesses are not well-understood in the United States.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methodology\/ principal findings<\/jats:title>\n<jats:p>We used data from the Healthcare Cost and Utilization Project\u2019s National Inpatient Sample to obtain yearly national estimates of chromoblastomycosis and phaeohyphomycotic abscess-associated hospitalizations. We examined age group, sex, Census region, season of hospital admission, clinical form of chromoblastomycosis, and presence of selected concurrent conditions. An estimated 690 chromoblastomycosis and phaeohyphomycotic abscess-associated hospitalizations occurred during 2016\u20132021. Rates were highest in 2016 (0.5\/1,000,000) and lowest in 2020 (0.2\/1,000,000). Overall, higher hospitalization rates occurred among males (0.4\/1,000,000) versus females (0.3\/1,000,000). Rates increased with age, with patients aged \u226565 years having the highest rate (0.9\/1,000,000). The Northeast had the highest hospitalization rate (0.5\/1,000,000) followed by the South (0.4\/1,000,000). Hypertension (34%), diabetes (33%), dyslipidemia (28%), and chronic kidney disease (21%) were the most common concurrent conditions. Nine percent had autoimmune inflammatory disease or solid malignancy. Seven percent had solid organ or stem cell transplantation. Subsequently, five percent had lymphedema. Mean hospitalization length was 9.9 days; in-hospital death occurred in 3%.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Conclusions\/significance<\/jats:title>\n<jats:p>Substantial in-hospital mortality and complications like lymphedema can occur from chromoblastomycosis and phaeohyphomycotic abscesses. Our analysis provides a baseline to monitor hospitalizations and mortality along with comorbidities that may change these outcomes. Public health and clinical partnerships could improve understanding of these fungal diseases caused by dematiaceous fungi through registries, enhanced surveillance, and increased awareness.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0013499","type":"journal-article","created":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T17:58:53Z","timestamp":1757008733000},"page":"e0013499","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Chromoblastomycosis and phaeohyphomycotic abscess-associated hospitalizations, United States, 2016\u20132021"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5707-528X","authenticated-orcid":true,"given":"Dallas J.","family":"Smith","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaitlin","family":"Benedict","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shawn R.","family":"Lockhart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay G.","family":"Revankar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,9,4]]},"reference":[{"issue":"11","key":"pntd.0013499.ref001","doi-asserted-by":"crossref","first-page":"100907","DOI":"10.1016\/S2666-5247(24)00139-3","article-title":"Reappraising Cladophialophora bantiana phaeohyphomycosis in France: retrospective nation-based study","volume":"5","author":"O Lortholary","year":"2024","journal-title":"Lancet Microbe"},{"issue":"4","key":"pntd.0013499.ref002","doi-asserted-by":"crossref","DOI":"10.1093\/ofid\/ofx200","article-title":"A mycoses study group international prospective study of phaeohyphomycosis: an analysis of 99 proven\/probable cases","volume":"4","author":"SG Revankar","year":"2017","journal-title":"Open Forum Infect Dis"},{"issue":"6","key":"pntd.0013499.ref003","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1016\/S1473-3099(09)70131-8","article-title":"Cerebral phaeohyphomycosis--a cure at what lengths?","volume":"9","author":"DM Li","year":"2009","journal-title":"Lancet Infect Dis"},{"issue":"12","key":"pntd.0013499.ref004","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1128\/jcm.01068-24","article-title":"The brief case: hidden in plain sight\u2014 Exophiala jeanselmei subcutaneous phaeohyphomycosis of hand masquerading as a hematoma","volume":"62","author":"CP Heath","year":"2024","journal-title":"J Clin Microbiol"},{"issue":"10","key":"pntd.0013499.ref005","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0012562","article-title":"A global chromoblastomycosis strategy and development of the global chromoblastomycosis working group","volume":"18","author":"DJ Smith","year":"2024","journal-title":"PLoS Negl Trop Dis"},{"issue":"1","key":"pntd.0013499.ref006","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1080\/13693780802538001","article-title":"Chromoblastomycosis: an overview of clinical manifestations, diagnosis and treatment","volume":"47","author":"F Queiroz-Telles","year":"2009","journal-title":"Med Mycol"},{"key":"pntd.0013499.ref007","unstructured":"World Health Organization. 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Census Regions and Divisions of the United States. https:\/\/www2.census.gov\/geo\/pdfs\/maps-data\/maps\/reference\/us_regdiv.pdf Accessed 2025 March 27."},{"issue":"1","key":"pntd.0013499.ref011","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/bjd\/ljad131","article-title":"Three years on, COVID-19 and the skin: long-term impacts, emerging trends and clinical practice","volume":"189","author":"EE Freeman","year":"2023","journal-title":"Br J Dermatol"},{"issue":"10","key":"pntd.0013499.ref012","doi-asserted-by":"crossref","DOI":"10.3201\/eid2810.220391","article-title":"Demographic and socioeconomic factors associated with fungal infection risk, United States, 2019","volume":"28","author":"E Rayens","year":"2022","journal-title":"Emerg Infect Dis"},{"issue":"6","key":"pntd.0013499.ref013","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1111\/myc.13449","article-title":"Let\u2019s talk about sex characteristics-As a risk factor for invasive fungal diseases","volume":"65","author":"M Egger","year":"2022","journal-title":"Mycoses"},{"issue":"4","key":"pntd.0013499.ref014","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1086\/322685","article-title":"Fungal infections in older adults","volume":"33","author":"CA Kauffman","year":"2001","journal-title":"Clin Infect Dis"},{"issue":"1","key":"pntd.0013499.ref015","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1128\/CMR.00032-16","article-title":"Chromoblastomycosis","volume":"30","author":"F Queiroz-Telles","year":"2017","journal-title":"Clin Microbiol Rev"},{"issue":"10","key":"pntd.0013499.ref016","doi-asserted-by":"crossref","first-page":"1500","DOI":"10.1093\/cid\/civ104","article-title":"Squamous cell carcinoma derived from chronic chromoblastomycosis in Brazil","volume":"60","author":"CMPS Azevedo","year":"2015","journal-title":"Clin Infect Dis"}],"updated-by":[{"DOI":"10.1371\/journal.pntd.0013499","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T00:00:00Z","timestamp":1757376000000}}],"container-title":["PLOS Neglected Tropical Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0013499","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T17:55:18Z","timestamp":1757440518000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0013499"}},"subtitle":[],"editor":[{"given":"Felix","family":"Bongomin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,9,4]]},"references-count":16,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,9,4]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pntd.0013499","relation":{"new_version":[{"id-type":"doi","id":"10.1371\/journal.pntd.0013499","asserted-by":"object"}]},"ISSN":["1935-2735"],"issn-type":[{"value":"1935-2735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,4]]}}}