Fungal infections lethal, overlooked

Doctors are urgently warning that fungal infections can be lethal, despite the fact that they are frequently overlooked as the cause of death. Although in the vast majority of cases fungal infection is not detrimental to health, the fungi may invade a weakened organism causing serious damage, say doctors from the German-Speaking Mycological Society. The association of 800 practising mycologists, or fungi specialists, met in Marburg (Hesse state) recently. Research by the Berlin-based mycologist Dr Hans-Juergen Tietz revealed that fungal infection plays a role in 4,000 to 5,000 deaths in Germany every year. His projections are based on a long-term study by Berlin’s Charite University Clinic. Over the last 23 years, post-mortems have been carried out on almost all corpses passing through the clinic. “In 13,375 autopsies, we singled out fungi as the cause in 93 cases,” says the microbiologist. In many cases, however, another cause was given on the death certificate. Some 150 types of fungus can cause illness in humans, notes Dr. Hans Christian Korting, a professor at Ludwig Maximilian’s University in Munich and chairman of the Mycological Society. Ten to 20 fungi regularly act as triggers to another disease, while the rest are considered “exotica”. Experts put the number of different fungi at between 100,000 and a million - from “athlete’s foot” to the mushroom. But while athlete’s foot - a contagious disease caused by a fungus affects almost one in three of Germans without them even being aware of it, internal fungal infection affected the body’s organs are extremely rare. They generally appear when the immune system has been weakened, for example following chemotherapy or organ transplantation. Germs which generally exist benignly on the skin, in the mouth or the vagina, then invade the body, infecting the lungs and other organs quickly as they are transported along blood vessels. In the worst case they can enter the brain, explains Tietz. The doctors at the Charite also examined the brains of 3,770 corpses, diagnosing fungal infection in 28 cases. “They quite literally eat out black holes in the brain,” says Tietz. And yet the patients appeared to be quite healthy and did not display symptoms typical of cerebral illness. Fungi were attributed to the cause of the death in only six of the 28 cases. Mycologists are alarmed at the growing number of germs which appear to be resistant to available anti-fungal remedies. One reason may be that humans tend to resort too quickly to preparations which defend against infection. “A simple fungal outbreak does not necessarily require treatment,” says Korting. “Antimycotic agents are only necessary when fungi cause sickness.” In addition, the use of fungicides on crops promotes the evolution of resistant fungi. Dr. Isaak Effendy, of Bielefeld, is annoyed that fungal infections are resisting eradication: “We can fly to the moon, but we don’t possess effective antimycotic agents,” the family doctor complained at the Marburg conference. The pharmaceutical industry in Europe was not doing enough to counter fungi, Effendy contended. dpa