Burden of Fungal Diseases in the United States

Fungal diseases can cause serious illness and death. Scientists are still learning about how many people in the United States are affected.

The burden is difficult to estimate because: 1

  • Many fungal diseases go undiagnosed.
  • There is no public health surveillance for common fungal infections, such as ringworm and vaginal candidiasis.

CDC estimates that:

  • Fungal diseases cost $7.2 billion in direct medical costs in 2017 based on administrative coding data (table). The total costs are likely much higher when including indirect and societal costs. 2
  • There were over 75,000 hospitalizations and nearly 9 million outpatient visits for fungal diseases in 2017 (table); however, these numbers likely represent substantial underestimates because of underdiagnosis and undercoding. 2
  • There were approximately 23,000 cases of invasive candidiasis in 2017. 3
  • There were more than 100,000 cases of coccidioidomycosis (Valley fever) in 2014. 4

Estimated hospitalizations, outpatient visits, and direct medical costs associated with fungal diseases in the United States in 2017.*

Estimated hospitalizations, outpatient visits, and direct medical costs associated with fungal diseases in the United States in 2017.
Disease Number of hospitalizations Number of outpatient visits Total direct medical costs ($)
Aspergillus infection 14,820 ** 1,254,833,662
Blastomycosis 950 ** 23,391,998
Candida infection*** 26,735 3,648,715 3,006,855,619
Coccidioidomycosis 6,670 ** 198,456,142
Cryptococcus (C. gattii and C. neoformans) infection 4,755 ** 257,736,014
Dermatophyte infections (e.g., ringworm) 690 4,981,444 821,433,855
Histoplasmosis 4,630 79,993 216,132,080
Pneumocystis pneumonia 10,590 ** 475,394,902
Mucormycosis 1,140 ** 125,350,373
Uncommon and opportunistic mycoses 5,585 ** 565,827,281
Other and unspecified mycoses 1,770 204,780 306,063,348
Total 75,055 8,993,230 7,251,475,272

* These numbers are based on administrative coding data and likely underestimate the true burden of disease because of underdiagnosis and undercoding.
** Estimate suppressed because of small numbers
*** Includes both non-invasive and invasive forms

References
  1. Vallabhaneni S, Mody RK, Walker T, Chiller T. The global burden of fungal diseasesexternal icon. Infect Dis Clin North Am. 2016 Mar
  2. Benedict K, Jackson BR, Chiller T, Beer KD. Estimation of direct healthcare costs of fungal diseases in the United Statesexternal icon. Clin Infect Dis. 2019 May 17
  3. Tsay S, Williams S, Mu Y, Epson E, Johnston H, Farley MM, et al. National burden of candidemia, United States, 2017external icon. Open Forum Infect Dis. 2018 Nov
  4. Freedman M, Anderson S, Benedict K, McCotter O, Derado G, Hoekstra R, et al. Preliminary estimates of annual burden of coccidioidomycosis in the United States, 2010–2014. 7th International Coccidioidomycosis Symposium, Stanford, CA; 2017.