Oral, oesophageal and vulvovaginal candidiasis (thrush)

  • Oral thrush also occurs in normal babies, people taking inhaled steroids for asthma, following radiotherapy to the head and neck for cancer, in denture wearers and in some leukaemia and transplant patients.
  • Candida infection of the oesophagus (gullet) affects an estimated ~1.4 million people.
  • Repeated attacks of vulvovaginal candidiasis affect at least 135 million women annually, The impact of on quality of life is substantial. About 70% of all premenopausal woman develop thrush at some point in their lives.

Invasive and life-threatening fungal infection

Candida infection

  • ~400,000 cases of Candidaemia predicted worldwide, with a mortality of 30-55%.
  • Candida peritonitis about 60,000 – 100,000 cases each year. The mortality of Candida peritonitis was 38%.
  • Around 150,000 of the 7.5 million patients admitted to intensive care (ICU) in Europe, USA and Japan each year grow Candida in their urine and is a common finding in hospitalised patients18 and those with catheters.

Invasive aspergillosis

  • Over 10 million patients in Europe, USA and Japan are at risk of invasive aspergillosis (IA) each year.
  • Over 300,000 patients develop IA annually.
    • ~10% of acute leukaemia (300,000 new cases annually)
    • stem cell and other transplants (>75,000 annually in the USA, Europe and Japan) (7,500 IA cases)
    • 1.3-3.9% of COPD patients admitted to hospital
    • liver failure in China documented a 5% rate, with a 95% mortality

Cryptococcal meningitis

  • 278,000 people develop cryptococcal meningitis in AIDS, each year

Pneumocystis pneumonia

  • About ~2.8 million HIV/AIDS infected patients who should be receiving anti-retroviral therapy are at risk as well as many other immunocompromised patients
  • Pneumocystis pneumonia has a 10-30% mortality in the USA and UK
  • Precise estimates of annual incidence are difficult because of diagnostic deficiencies but case numbers certainly exceed 400,000 globally per year.

Mucormycosis

  • A population estimate from the USA of 2 cases of mucormycosis per million and from France of 0.6 per million. The projected annual incidence is as high as 13 per 100,000.

Allergic fungal disease

Allergic bronchopulmonary aspergillosis (ABPA)

  •  Approximately 4.8 million people develop ABPA among the 193 million adults with active asthma worldwide.
  • ~ 15% of people with cystic fibrosis develop ABPA, ~9,000 affected. Severe Asthma with Fungal Sensitisation (SAFS)
  • SAFS is predicted to affect ~6.5 million (range 3.25-13 million) adults worldwide depending on the frequency of severe asthma (5-20% of all asthmatics).

Allergic fungal sinusitis

  • Allergic fungal sinusitis and rhinitis affects ~12 million people at any time.

Chronic fungal disease

  • Chronic pulmonary aspergillosis complicates many respiratory disorders including tuberculosis, ABPA, sarcoidosis and COPD, and so the total burden of this debilitating disorder is ~3 million.
  • About 25,000 cases of coccidioidomycosis occur in the US each year, and many more in Central and South America.
  • Up to 50 million people are thought to have been infected with histoplasmosis, with ~500,000 new infections each year, most asymptomatic and based on skin testing.

Fungal eye infections

  • Estimates of the annual incidence of fungal keratitis vary from 1 million to 6 million in SE Asia annually. Among causes of avoidable blindness, corneal opacities (caused by fungi or bacteria) accounts for 10% of the 284 million people visually impaired worldwide.

Cutaneous fungal infections

  • Fungal nail infection (onychomycosis) is common in the general adult population, probably 5-25% rate with an increasing incidence in elderly people.
  • Athlete’s foot (tinea pedis) is more common than onychomycosis and is more common in younger people and sportsmen.
  • Hair infection (tinea capitis) is most common among children, often resulting in bald patches with psychosocial consequences.Suggested a global prevalence of 200 million cases.

 

The Fungal Infection Trust April 2014

Full article: how-common-are-fungal-diseases