Global guideline for the diagnosis and management of the endemic mycoses: an initiative of the European Confederation of Medical Mycology in cooperation with the International Society for Human and Animal Mycology.

The global burden of the endemic mycoses (blastomycosis, coccidioidomycosis, emergomycosis, histoplasmosis, paracoccidioidomycosis, sporotrichosis, and talaromycosis) continues to rise yearly and these infectious diseases remain a leading cause of patient morbidity and mortality worldwide. Management of the associated pathogens requires a thorough understanding of the epidemiology, risk factors, diagnostic methods and performance characteristics in different patient populations, and treatment options unique to each infection. Guidance on the management of these infections has the potential to improve prognosis. The recommendations outlined in this Review are part of the "One World, One Guideline" initiative of the European Confederation of Medical Mycology. Experts from 23 countries contributed to the development of these guidelines. The aim of this Review is to provide an up-to-date consensus and practical guidance in clinical decision making, by engaging physicians and scientists involved in various aspects of clinical management.

Gigantic amoebic liver abscess in pregnancy: A case report.

Amoebic liver abscess in pregnancy is genuinely rare in its presentation. Yet, the main issue surrounding this agenda is the diagnostic challenge that it poses especially when symptomatology is vague and clues are subtle which altogether evades the diagnosis proper. We would like to dwell mainly on these issues in hopes of enlightening clinicians towards these diagnostic dilemmas. We report an extremely rare case of amoebic liver abscess occurring in the third trimester of pregnancy in a 29-year-old lady living in an interior village in Sabah. It was a combination of biochemical, radiographic and molecular investigations that ultimately led to the final diagnosis. In lieu of the high risk of mortality amongst pregnant mothers afflicted with amoebic liver abscess, the inherent need for early diagnosis requiring a high index of suspicion is vital. Elevated alkaline phosphatase alongside neutrophilia appears to be the most consistent liver parameters in guiding clinicians towards the presence of liver abscess.