Epidemiology of Histopathologically Diagnosed Mycoses: The Ibadan 37 Years Experience

Background: Recent studies suggest that the occurrence of mycotic infections is increasing worldwide, due to predisposing factors such as immunosuppression from chemotherapy, surgery, HIV/AIDS and debilitating diseases, but there is paucity of information regarding fungal infections in our environment.

Aim: This study aimed to characterise mycoses diagnosed histopathologically in the Department of Pathology, University College Hospital (UCH), Ibadan between 1970 and 2006.

Methods: The surgical pathology and autopsy records of all mycoses diagnosed during the study period were retrieved and analysed. One hundred and eighty-six mycoses were recruited.

Results: There was a progressive decline in the annual occurrence of mycoses from 19.7% to 1.1%. The cases comprised 121 males and 65 females, whose ages ranged from 6 weeks to 80 years, with 68.3% being less than 40 years of age. The mean age of the male patients (29.9±18.4 years) was not significantly different from that of the females (27.4±18.2 years), t = 0.867, df = 186, p = 0.387. The most common mycotic infections were African histoplasmosis (28%), aspergillosis (12.4%), mycetoma (9.7%), candidiasis (8.6%) and actinomycosis (7%). Systemic mycoses accounted for 62%, followed by subcutaneous mycoses (21%), cutaneous mycoses (11%) and superficial mycoses (6%). The most common sites involved were the skin (23.7%), upper and lower limbs (15.6%), nose (11.3%) and lungs (7%).

Conclusion: The present study has demonstrated that fungal infections are common and account for significant morbidity and disease burden in our environment.