Challenges in invasive fungal disease

Abstract

The term invasive fungal disease (IFD) incorporates severe systemic or deep-seated infections due to fungi. A rise in the prevalence of IFD has been observed in recent years, primarily due to the rising numbers of susceptible host population, increasing invasive therapeutic interventions and immunosuppressive treatments. In addition, the expanding spectrum of fungal pathogenicity, rise in infection due to previously obscure fungi, and development of fungal thermal adaptation are also main concerns. Challenge also lies in diagnostics due to the absence of validated, prompt, and accurate diagnostic test for IFD and also differentiating infection from mere colonization. Factors related to antifungal treatment, such as point of initiation, duration of treatment, lack of ideal drug with good pharmacokinetics and pharmacodynamics, drug toxicity, and difficulty in accessing antifungal drugs affect the patient outcome. The rise in antifungal resistance, which stems from incoherent antifungal use in clinical practice and the agriculture industry, is also a matter of concern. Although IFD continues to threaten humans worldwide, our understanding of the factors affecting its changing epidemiology is still not clear. Educating clinicians and laboratory personnel about the complex issues regarding IFD diagnosis and management is essential.