**1. Introduction**

In 2017, the World Health Organization (WHO) created the first list of bacterial priority pathogens (WHO BPPL) and inspired by it, the first list of fungal priority pathogens (WHO FPPL) appeared [1].

The pathogens were classified into three groups according to their ability to cause invasive systemic infections that pose challenges in treatment and/or management or drug resistance: critical, high, and intermediate. *Histoplasma capsulatum* belongs to the high group. Three action areas and strategies were proposed:

1.Improvement of mycological laboratory diagnostic capacity and surveillance, optimization, and standardization of diagnostic tools worldwide;


The geographic distribution of *Histoplasma capsulatum* has changed. It is underestimated because of inadequate public health measures (surveillance and reporting), uneven and unequal access to health care facilities and diagnostic tests (the disease burdens resource-poor regions), climate change, environmental disturbances, improved clinical and laboratory diagnostic detection, and increases in at-risk populations (travelers, immunocompromised patients). Global annual incidence rates for this disease, its distribution, and trends in specific countries or regions are unavailable due to lack of studies. In addition, there is no vaccine, progression to the invasive form is not preventable, access to diagnostics is moderate, and diagnosis for invasive forms is challenging.

Most laboratories have basic tests and only a few have tools such as molecular testing, next-generation sequencing, or other approved tests for histoplasmosis that allow diagnosis of fungal infection when there is high suspicion of the infection.

Diagnosis of Histoplasmosis (HPM) is difficult and requires a multifactorial approach (**Table 1**). Identification of *Histoplasma capsulatum* (*H*. *capsulatum*) by direct microscopy based on characteristic intracellular yeasts and/or culture isolation of the fungus in biological specimens is the gold standard for diagnosis. However, these tests have their limitations:


In this regard, immunologic methods of antibody and antigen detection in clinical specimens such as serum, plasma, cerebrospinal fluid, urine, and bronchoalveolar lavage (BAL), as well as fungal DNA detection, are options for presumptive diagnosis of HPM. Analytical performance of assays for the diagnosis of histoplasmosis varies depending on disease stage and clinical form (**Table 2**).
