Contribution of fungal diseases to the U.S. chronic disease burden

SUMMARYChronic diseases, defined as conditions that persist for 1 or more years and require ongoing medical attention or impede daily life, represent an urgent public health challenge in the United States. In the last decade, fungal infections have garnered increased attention from public health officials and the media owing to the rapid and global rise of severe and antifungal-resistant infections. It is well-established that certain chronic diseases can increase the risk of invasive fungal infections. However, the inverse relationship-how fungal infections contribute to the development or exacerbation of chronic diseases-is less well studied. In this review, we summarize the current literature on the role of fungal infections in the development of chronic diseases, discussing pathophysiologic mechanisms and examining how chronic conditions can arise from the direct effects and sequelae of fungal infections. In addition, we discuss how the toxic effects of antifungal therapies can also contribute to the development of chronic disease states. Overall, our review highlights the significant yet underexplored role of fungal infections in the burden of chronic disease and emphasizes the need for further research, improved surveillance, increased public and healthcare awareness, and better access to diagnostics and treatments to address this issue.