Globally, over 300 million people are afflicted with a serious fungal infection and 25 milllion are at high risk of dying or losing their sight. Estimates for the global burden of fungal diseases are based on population and disease demographics (age, gender, HIV infected, asthma etc)1. Some fungal diseases are acute and severe (i.e. cryptococcal meningitis and fungal eye infection (keratitis), other recurrent (i.e. Candida vaginitis or oral candidiasis in AIDS) and other chronic (i.e. chronic pulmonary aspergillosis or fungal hair infection (tinea capitis). The most common life-threatening fungal infections and estimated overall mortality are shown below.
(ABPA, allergic bronchopulmonary aspergillosis; AIDS, acquired immunodeficiency syndrome; COPD, chronic obstructive pulmonary disease; CPA, chronic pulmonary aspergillosis; Crypto, cryptococcosis; Histo, histoplasmosis; IA, invasive aspergillosis; IC, invasive candidiasis; PCP, Pneumocystis pneumonia; SAFS, severe asthma with fungal sensitization; TB, tuberculosis)
| Fungal infection | Number affected | Case fatality rate | Estimated deaths | Comments |
|---|---|---|---|---|
| Cryptococcal meningitis | 223,000 in AIDS | 15-20% USA >50% developing world |
180,000 in AIDS | CDC estimate |
| Pneumocystis pneumonia | >400,000 in AIDS >100,000 in non-AIDS |
~15% in AIDS with best treatment ~50% in non-AIDS |
>200,000 in AIDS >50,000 non-AIDS |
Most cases in Africa not diagnosed and 100% mortality |
| Disseminated histoplasmosis | ~100,000 | 15-30%, if diagnosed and treated | >80,000 | Most common in the Americas |
| Invasive aspergillosis | >1,000,000 | ~30% mortality in leukaemia in HIC
~45-70% in COPD ~30% mortality if treated in HIC -in AIDS |
>500,000
>30,000 in AIDS >125,000 in non-AIDS |
Many missed diagnoses globally |
| Invasive candidiasis | >750,000 | ~40% mortality treated | >350,000 | |
| Chronic pulmonary aspergillosis | >3,000,000 | ~15-40% mortality in HIC ~15% mortality in the developed world |
>450,000 in non hospitalised populations | Under-diagnosed and mistaken for tuberculosis |
| Severe asthma with fungal sensitisation (SAFS) | >6,500,000 | <1% but no good figures. | 350,000 – 489,000 asthma deaths ~50% related to SAFS |
Uncertain |
| Fungal keratitis | 1-0-1.4 million | Blinding >60% | >600,000 blind eyes | Diagnosis often late |
| Total | ~13,500,000 | >1,600,000 | Probably a significant underestimate |
