Gupta Aditya K, Thornbush Mary, Wang Tong
Division of Dermatology, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Mediprobe Research Inc., London, Ontario, Canada.
Int J Dermatol. 2025 Aug;64(8):1349-1355. doi: 10.1111/ijd.17908. Epub 2025 Jun 12.
Fungal infections are an important source of morbidity and mortality that can manifest as superficial or invasive diseases. Diagnostic techniques for human fungal pathogens remain problematic, and multi-drug resistance is emerging. This review addresses the potential emergence of new fungal pathogens in changing environments and reported instances of cutaneous fungal infections after natural disasters. Global warming does more than increase the mean global temperature; it is associated with changing precipitation patterns and major climatic events. With natural disasters, niches are created for the proliferation of fungal pathogens affecting humans across previously existing geographical boundaries. Here, we reviewed reports of cutaneous fungal infections after natural disasters, including earthquakes, floods, tsunamis, hurricanes, and tornadoes. Of importance is the potential for thermal adaptation leading to the evolution of new human pathogens, exacerbated by the elevated environmental fungal levels in disaster situations. Studies have documented higher risks of contracting typical tinea infections, as well as opportunistic, trauma-related infections by environmental fungi. The latter is especially concerning due to atypical clinical presentations that could lead to treatment delays, antifungal resistance, and systemic complications. These support the importance of considering climate change as affecting the adaptation of these pathogens and the consequences of this change for human populations. A One Health framework should be advocated to address the impact of climate change on dermatological care.
真菌感染是发病率和死亡率的重要来源，可表现为浅表性或侵袭性疾病。人类真菌病原体的诊断技术仍然存在问题，而且多重耐药性正在出现。本综述探讨了在不断变化的环境中可能出现的新型真菌病原体，以及自然灾害后皮肤真菌感染的报告实例。全球变暖不仅仅是提高了全球平均温度；它还与降水模式的变化和重大气候事件有关。随着自然灾害的发生，为影响人类的真菌病原体跨越先前存在的地理边界扩散创造了生态位。在此，我们回顾了自然灾害后皮肤真菌感染的报告，包括地震、洪水、海啸、飓风和龙卷风。重要的是，热适应有可能导致新型人类病原体的进化，而灾害情况下环境真菌水平的升高会加剧这种情况。研究记录了感染典型癣菌感染以及环境真菌引起的机会性、创伤相关感染的更高风险。后者尤其令人担忧，因为非典型临床表现可能导致治疗延误、抗真菌耐药性和全身并发症。这些都支持了将气候变化视为影响这些病原体适应性及其对人类种群影响的重要性。应倡导采用“同一健康”框架来应对气候变化对皮肤病护理的影响。
