Endemic mycoses remain a significant cause of morbidity and mortality among immunocompromised patients. As the number of immunosuppressed individuals increases worldwide, the incidence of endemic mycoses is also expected to rise. In immunocompromised patients, endemic mycoses can present in atypical fashion, cause more severe and/or disseminated disease, and result in higher mortality. Despite several noteworthy advances over the past decade, significant challenges remain with regard to the prevention, diagnosis, and therapy of endemic mycoses in immunocompromised hosts. This review highlights important developments related to the epidemiology, diagnosis, treatment, and prevention of commonly encountered endemic mycoses. We also discuss emerging topics, knowledge gaps, and areas of future research.

We monitored natural and artificial nests during a two-part study on East Maui, Hawaii, designed to examine factors influencing nest depredation by black and Polynesian rats. The first half of the study examined the effects of rat control on nest depredation within portions of the Hanawi Natural Area Reserve. Rat density monitoring indicated control efforts had significantly reduced black rat captures in treatment areas, but no differences in survival of artificial or natural nests between treatment and control areas were observed. The second half of the study examined the effect of nesting substrate on nest depredation in the Makawao Forest Reserve during June 2003 and June 2004. We chose fruiting and non-fruiting nest substrates for artificial nests in two habitat types, native ohia/koa forest and an adjoining forest dominated by non-native tropical ash. Results from snap trapping showed that the relative density of black rats was significantly higher in the ohia/koa forest than the tropical ash forest, but plots with more rat captures did not always have higher rates of nest depredation as predicted. Our findings suggest that there is a large degree of variability in nest depredation by Rattus spp., but that rat density, forest type, and nest substrate influence nest depredation rates.