It took doctors a month to figure out a fungus had infected Glenda Brame’s bloodstream. The delay likely led to her death.
The 56-year-old died in September, felled by a fungus that kills between 30% and 60% of people it infects. Brame had exhibited signs of a serious infection for weeks, her medical records show. Doctors at Horizon Specialty Hospital in Las Vegas suspected bacteria and gave her antibiotics. Her infection worsened.
“They kept pumping her full of antibiotics,” said her husband, Malcolm Brame.
Brame’s death could have been prevented had doctors promptly treated the fungal infection, according to infectious-disease specialists who reviewed her case but weren’t involved in her care. Horizon said it had followed infection-control protocols to prevent and curb the spread of the fungus.
Severe fungal disease used to be a freak occurrence. Now it is a threat to millions of vulnerable Americans, and treatments have been losing efficacy as fungal pathogens develop resistance to standard drugs.
Medical experts say one reason for the surge is that more people have compromised immune systems, including cancer patients and those taking medicines after organ transplants. Compounding the problem, research shows, is that rising temperatures appear to have expanded the geographical range of some deadly fungal pathogens, and possibly made them better adapted to human hosts.
“It’s going to get worse,” said Dr. Tom Chiller, head of the fungal-disease branch of the Centers for Disease Control and Prevention.
The failure of some doctors to recognize quickly enough what is happening to stricken patients is causing deaths and complications they could have prevented.
“Fungi aren’t being given enough thought,” said Dr. Peter Pappas, an infectious-disease specialist at the University of Alabama at Birmingham. “When symptoms can’t be explained, fungi should be one of the first things you think about.”
Hazardous fungi are everywhere. They live inside our bodies and on our skin. They are abundant in the air, water and soil.
Healthy people typically keep them at bay, but when immunity is compromised, yeasts and molds can invade the bloodstream, lungs, brain and other organs. Most at risk are the estimated 10 million people in the U.S. whose immune systems have been weakened.
Diagnosing a dangerous fungal infection early makes it more likely a patient will survive. Delaying treatment of some fungal disease by just a day can double the risk of death, research shows. Yet treatment often is delayed because doctors fail to consider fungus.
A 2022 survey of 500 infectious-disease doctors by researchers at the University of Iowa and University of California, San Francisco, identified fungal infections as among the diseases most frequently diagnosed late. Failure to consider fungal disease was most often to blame, the doctors said.
Almost half of some 270 patients in Arizona with the fungal disease Valley Fever weren’t correctly diagnosed for a month or more, a 2019 paper showed. A 2020 study found that one in four patients hospitalized with symptoms of the fungus Cryptococcus were first misdiagnosed.
“In medicine, fungi are an afterthought,” said Dr. Andrej Spec, an infectious-disease specialist at Washington University in St. Louis. “We need a paradigm shift.” –
Studies have shown that as the climate changes, Histoplasma and other fungi have expanded their geographic range and become more adept at infecting people. Some fungi appear to have adapted to warmer temperatures, potentially making them better suited to surviving inside humans, the studies show.
Like bacteria that mutate to better resist antibiotics, fungi are evolving to withstand available treatments. Drug-resistant bacteria and fungi kill more than 35,000 people in the U.S. every year, according to the CDC.
Common illnesses such as Covid-19 can make people vulnerable to fungal disease. At least 2,800 people died in the U.S. from Covid-related fungal infections in 2020 and 2021, the CDC said.
