Mycoses. 2019;62:1043–1048. wileyonlinelibrary.com/journal/myc | 1043 © 2019 Blackwell Verlag GmbH 1 | INTRODUCTION The number of serious fungal infections is increasing worldwide due to the rising size of the population at risk. Fungi primarily infect im‐ munocompromised patients, such as those undergoing chemother‐ apy or infected with human immunodeficiency virus (HIV), and those acquired in hospitals. However, fungal infections in healthy individ‐ uals are also increasing. 1 Over 300 million people suffer from seri‐ ous fungal‐related disease, and the annual mortality due to fungal infections is estimated to be over 1.6 million. Although, Candida, Aspergillus, Pneumocystis and Cryptococcus spp. are the most com‐ mon cause of the serious fungal infections in Europe, there has been an increase in the incidence of infections caused by other filamen‐ tous fungi such as mucormycosis. 2 Superficial infections of the nails and skin are the most common fungal diseases in humans and affect ~25% of the general popula‐ tion worldwide. 3 These infections are caused primarily by dermato‐ phytes. The clinical appearance and the causative fungi and species Accepted: 30 July 2019 DOI: 10.1111/myc.12981 ORIGINAL ARTICLE Estimated burden of fungal infections in Sweden Volkan Özenci 1,2 | Lena Klingspor 1 | Måns Ullberg 2 | Erja Chryssanthou 1,2 | David W. Denning 3 | Nahid Kondori 4,5 1 Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden 2 Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden 3 National Aspergillosis Centre, Wythenshawe Hospital, The University of Manchester, Manchester, UK 4 Department of Infectious Diseases, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden 5 Department of Clinical Microbiology, Sahlgrenska University Hospital, Gothenburg, Sweden Correspondence Volkan Özenci, Division of Clinical Microbiology F 72, Karolinska Institutet, Karolinska University Hospital, Huddinge, SE 141 86 Stockholm, Sweden. Email: volkan.ozenci@sll.se Summary The aim of this study was to estimate the annual burden of fungal infections in Sweden using data mainly from 2016. Data on specific populations were obtained from Swedish national data registries. Annual incidence and prevalence of fungal disease was calcu‐ lated based on epidemiological studies. Data on infections due to Cryptococcus sp., Mucorales, Histoplasma capsulatum, Coccidioides immitis and Pneumocystis jirovecii were retrieved from Karolinska University Laboratory and covers only 25% of Swedish population. In 2016, the population of Sweden was 9 995 153 (49.8% female). The overall burden of fungal infections was 1 713 385 (17 142/100 000). Superficial fungal infections affect 1 429 307 people (1429/100 000) based on Global Burden of Disease 14.3% prevalence. Total serious fungal infection burden was 284 174 (2843/100 000) in 2016. Recurrent Candida vulvovaginitis is common; assuming a 6% prevalence in women. Prevalence of allergic bronchopulmonary aspergillosis and severe asthma with fungal sensitisation were estimated to be 20 095 and 26 387, respectively. Similarly, chronic pulmonary aspergillosis was estimated to affect 490 patients after tuberculo‐ sis, sarcoidosis and other conditions. Candidemia incidence was estimated to be 500 in 2016 (4.7/100 000) and invasive aspergillosis 295 (3.0/100 000). In Stockholm area, Mucorales were reported in three patients in 2015, while Cryptococcus spp. were re‐ ported in two patients. In 2016, there were 297 patients PCR positive for P jirovecii. The present study shows that the overall burden of fungal infections in Sweden is high and affects 17% of the population. The morbidity, mortality and the healthcare‐re‐ lated costs due to fungal infections warrant further studies. KEYWORDS epidemiology, fungal infections