Mahendra Pal^1,, Mahek Desai², Tesfaye Rebuma³, Pratibha Dave⁴, Claudete Rodrigues Paula⁵, Neelima Ranjan⁶, Oskar Nowak⁷

Fungal infections constitute an increasingly important global public health problem and are associated with substantial morbidity and mortality, particularly among immunocompromised and critically ill individuals. They range from highly prevalent superficial mycoses to invasive and disseminated infections with high case-fatality rates. Opportunistic pathogens, such as Aspergillus, Candida, Cryptococcus, Rhodotorula, Geotrichum, and Trichosporon cause diverse clinical syndromes, whereas endemic dimorphic fungi including Blastomyces, Coccidioides, Histoplasma, Paracoccidioides, and Talaromyces are strongly influenced by environmental and geographic exposure. Recent global estimates suggest that more than 6.5 million life-threatening invasive fungal infections occur annually, with approximately 3.8 million associated deaths. Climate change may alter fungal ecology, geographic distribution, and human exposure, while antifungal resistance increasingly compromises the effectiveness of the limited therapeutic options available. This review summarizes the epidemiology, major opportunistic and endemic mycoses, global morbidity and mortality, climate-related emergence, and antifungal resistance, and highlights the need for improved surveillance, laboratory diagnosis, antifungal stewardship, access to effective treatment, and coordinated One Health interventions.

Antifungal resistance, Climate change, Endemic mycoses, Fungal infections, Global burden, One Health, Opportunistic mycoses