Introduction

Abstract

Of nearly 1.5 million fungi in the environment, nearly 400-500 species are now known to cause human disease. The spectrum of fungi causing human infection is ever increasing with the rise of susceptible population at risk for invasive mycoses. This has happened largely due to climate change, healthcare related factors, and adaptation of fungi in human host. For all benefits to mankind, modern medicine has developed this expanding population with low immunity and anatomical barrier break. The traditional group of patients who are known to be at risk of acquiring fungal infections include the patients with hematological malignancies undergoing chemotherapy, transplant recipients, patients with AIDS, severe burns, prematurity, and autoimmune diseases. During the last decade, the range of susceptible patients has increased. New risk factors like admission in ICU, chronic liver and renal diseases, diabetes, and post H1N1 influenza are added to this list. Even the so-called immunocompetent hosts are occasionally found to acquire invasive fungal infections (IFIs) due to direct introduction of fungi through indwelling devices, trauma or due to exposure of large inoculums of fungal spores in respiratory tract. Fungal spore count in the environment of the hospital and community is very high in majority of the Asian countries [1]. The exact burden of IFIs in Asian countries is still not known, as the disease is largely unrecognized, not notified, and difficult to diagnose. The limitation of diagnostic mycology laboratories in those countries is another challenge [2]. The awareness of IFIs among clinicians is also limited to few tertiary care centers only. It is estimated that over 800 millions people globally suffer from IFIs and annual death due to IFIs (1,660,000) is comparable to malaria (445,000) or to tuberculosis (1,700,000) [3].