It is estimated that 1.5 million fungal species exist. And among them, 300 have shown virulence to humans. The incidence of fungal infections is increasing every year, with greater numbers of infections noted among patients belonging to high-risk groups such as HIV-infected persons and AIDS patients, transplant recipients, and immunosuppressed patients treated with chemotherapeutics or corticosteroids, as well as those suffering from hematological disorders and chronically ill patients (1).
Though fungal infections are uncommon but pose a threat to the life of patients.
How Long Does It Take For Fungal Infections To Clear Up?
It depends on the person immunity and type of fungal infection i.e. whether it is a superficial fungal infection or a deep tissue fungal infection (2).
Superficial Fungal Infections – Most superficial fungal infections of the skin are caused by dermatophytes or yeasts (3). Dermatophytes are fungi cause infections of the skin, hair, and nails. Superficial fungal infections can take anywhere from a few days to a few months to heal. They rarely cause serious illness, but fungal infections are often recurrent. The best example is tinea capitis, tinea cruris, tinea pedis, tinea corporis, tinea manuum and tinea barbae (4).
Deep Tissue Fungal Infection – Deep tissue fungal infection can take up to two years to treat. It has two different groups of conditions, the subcutaneous and systemic mycoses.
Subcutaneous Infections are caused by the traumatic implantation of the fungus into the skin, or very rarely, by inhalation into the lungs. It is dangerous if left untreated because they tend to spread other tissue or organ via lymphatic drainage (5).
Systemic mycosis is defined as an invasive fungal infection which is a more general term refers to fungemia. CNS involvement is reported in the majority of systemic mycosis. Systemic fungal infections are generally late manifestations of HIV disease. The most commonly occurring systemic mycosis in HIV-infected patients is cryptococcosis, histoplasmosis, and coccidioidomycosis (6).
Morbidity And Mortality
Invasive fungal infections have become a major source of morbidity and mortality over the past three decades. Fungal infections take more than 1.3 million lives each year worldwide, nearly as many as tuberculosis. More than a million people around the world are blind because of fungal infections of the eye. Half of the world’s 350,000 asthma-related deaths each year stem from fungal infection (7).
Factors Promoting Invasive Fungal Infections
Poor cellular immunity (e.g. while viral infection), certain drugs (cytotoxic drugs), mucosal barrier injury, unhygienic, genetic factor, increasing age of patients with co-morbidity, gastrointestinal surgery, neonatal intensive care (e.g. length of stay, intubation) are factors promoting invasive fungal infections (2).
Harmless Fungi To Virulence Fungi
During the last decades, an obvious change in pathogens has occurred. More aggressive treatment modalities can jeopardize the defense mechanisms to an extent that even fungi with a low intrinsic virulence enter the body to cause serious disease. Organisms that were previously considered harmless commensals have been held accountable for serious invasive fungal disease (2). Obviously, impaired cellular immunity is the reason that has been connected to the majority of the cases. Surgical removal of lesions is also possible and many cases, a combination of surgical intervention and antifungal therapy has increased the survival rate of patients (8).
Fungal infections, even though is rare, it pose a severe threat to the life of patients. Diagnosis and treatment are still a significant challenge. Superficial fungal infections can take from a few days to a few months to heal. Deep tissue fungal infection can take up to two years to treat. The choice of appropriate therapy is crucial in helping prevent the high mortality associated with fungal infections, and the choice of drug depends on fungi, its mode of action, and spectrum of activity.
- Global and Multi-National Prevalence of Fungal Diseases-Estimate Precision. Bongomin F, Gago S, Oladele RO, Denning DW J Fungi (Basel). 2017 Oct 18; 3(4):
- What Are Fungal Infections? Ben E. de Pauw. Mediterr J Hematol Infect Dis. 2011; 3(1).
- Superficial fungal infections of the skin. Diagnosis and current treatment recommendations.Drugs. 1992 May;43(5):674-82.
- Superficial fungal infections. Getting rid of lesions that don’t want to go away.Postgrad Med. 1995 Dec;98(6):61-2, 68-9, 73-5.
- Dermatol Ther. 2004;17(6):523-31. Subcutaneous fungal infections.
- Kathleen R. Page, Richard E. Chaisson, Merle Sande. Chapter 29 – Cryptococcosis and other fungal infections (histoplasmosis and coccidioidomycosis) in HIV-infected patients,2012.
- Fungal infections of the nervous system: current perspective and controversies in management. Raman Sharma R Int J Surg. 2010; 8(8):591-60