EPIDEMIOLOGY OF FUNGAL INFECTIONS (T CHILLER AND J BADDLEY, SECTION EDITORS) The Manaus Declaration: Current Situation of Histoplasmosis in the Americas, Report of the II Regional Meeting of the International Histoplasmosis Advocacy Group Diego H. Caceres 1 & Antoine Adenis 2 & João Vicente Braga de Souza 3 & Beatriz L. Gomez 4 & Katia Santana Cruz 5 & Alessandro C. Pasqualotto 6 & Giovanni Ravasi 7 & Freddy Perez 7 & Tom Chiller 1 & Marcus Vinicius Guimarares de Lacerda 8,9 & Mathieu Nacher 3 & The International Histoplasmosis Advocacy Group (iHAG) # This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2019 Abstract Purpose of Review The aim of this report is to summarize the conclusions of the II Regional Meeting on Histoplasmosis in the Americas held in Manaus, Brazil, on March 22–24, 2019. Recent Findings Persons living with advanced HIVare at high risk for developing histoplasmosis. Clinical signs and symptoms of this disease are often non-specific, making it difficult to establish a diagnosis. Although with the recent technological advances, in vitro diagnostics and medicines for histoplasmosis are often not available in many regions around the world. In addition, histoplasmosis is often not included in HIV care and treatment programs, resulting in inadequate health system planning and missed opportunities to save lives. Summary The II Regional Meeting on Histoplasmosis in the Americas gathered a multidisciplinary audience. Developed recommendations to be included in the WHO guidelines for diagnosis and treatment of histoplasmosis in advanced HIV were the product of this meeting, and guidelines are aimed to be published in early 2020. Keywords Histoplasma . Histoplasmosis . Diagnosis . Treatment . Guidelines . AIDS Introduction Histoplasmosis is a disease caused by the fungus Histoplasma capsulatum. This disease is most frequently found in the American continent, but it has also been reported in other places around the world. In persons living with HIV (PLHIV), especially those with advanced disease, progressive disseminated histoplasmosis (PDH) is associated with high This article is part of the Topical Collection on Epidemiology of Fungal Infections * Diego H. Caceres diegocaceres84@gmail.com; xju7@cdc.gov 1 Centers for Disease Control and Prevention, Mycotic Diseases Branch, Mailstop H24-9, 1600 Clifton Rd, Atlanta, GA 30333, USA 2 Centre d’Investigation Clinique Antilles Guyane, Inserm CIC1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana 3 Instituto Nacional de Pesquisas da Amazônia, Coordenação de Sociedade, ambiente e saúde, Laboratório de Micologia, Manaus, Amazonas AM 69060-001, Brazil 4 Studies in Translational Microbiology and Emerging Diseases (MICROS) Research Group, School of Medicine and Health Sciences, Universidad del Rosario, Bogota 11011, Colombia 5 Medical Mycology Laboratory, Tropical Medicine Foundation Dr. Heitor Vieira Dourado, Manaus, Amazonas AM 69060-001, Brazil 6 Universidade Federal de Ciências da Saúde Porto Alegre, and Santa Casa de misericórdia de Porto Alegre, Porto Alegre, RS, Brazil 7 HIV, Hepatitis, Tuberculosis and STI Unit, Pan American Health Organization, D, Washington .C, USA 8 Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD), Manaus, Amazonas, Brazil 9 Fundação Oswaldo Cruz, Instituto Leônidas e Maria Deane (FIOCRUZ-Amazonas), Manaus, Amazonas, Brazil Current Fungal Infection Reports https://doi.org/10.1007/s12281-019-00365-3