title: The emerging epidemiology of mould infections in developing countries.
abstract: OBJECTIVE
  The present review describes the emerging trends of mould infections in developing countries, and highlights the major epidemiological differences from the developed countries.
  
  
  RESULTS
  The limited data available from developing countries suggest an alarming increase in invasive mould infections, especially aspergillosis and mucormycosis, and also a difference in risk factors and causative agents between the developed and developing world. Sino-orbital, cerebral and ophthalmic infections due to Aspergillus flavus are the major clinical types in aspergillosis, after pulmonary aspergillosis. Aspergillus and Fusarium spp. are frequent causes of trauma-associated keratitis in agricultural workers. Rhino-orbito-cerebral presentation associated with uncontrolled diabetes is the predominant mucormycosis. Isolated renal mucormycosis has emerged as a new clinical entity. Apophysomyces elegans and Mucor irregularis are emerging species in these regions and uncommon agents such as Rhizopus homothallicus have also been reported. Many pathogens are geographically restricted, with Pythium insidionum, Rhinocladiella mackenziei and M. irregularis being described almost exclusively from Thailand, Middle East and China, respectively.
  
  
  CONCLUSIONS
  Despite limited studies, certain peculiarities have been observed in invasive mould infections in developing countries, including a high incidence of ophthalmic lesions, mucormycosis and aspergillosis; few different clinical presentations; and a varied spectrum of pathogens involved in such lesions.
authors.affiliation: Division of Mycology, Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. arunaloke@hotmail.com
authors.forename: Arunaloke
authors.initials: A
authors.lastname: Chakrabarti
authors.forename: Rachna
authors.initials: R
authors.lastname: Singh
mesh_terms: D001228:Aspergillosis / Q000453:epidemiology; D003906:Developing Countries / Q000706:statistics & numerical data*; D006801:Humans; D009091:Mucormycosis / Q000453:epidemiology; D009181:Mycoses / Q000453:epidemiology* / Q000382:microbiology; D015995:Prevalence; D012307:Risk Factors; D020096:Zygomycosis / Q000453:epidemiology