Let's talk about sex characteristics—As a risk factor for invasive fungal diseases

Matthias Egger, Martin Hoenigl, George R. Thompson, Agostinho Carvalho, Jeffrey D. Jenks

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Biological sex, which comprises differences in host sex hormone homeostasis and immune responses, can have a substantial impact on the epidemiology of infectious diseases. Comprehensive data on sex distributions in invasive fungal diseases (IFDs) are lacking. In this review, we performed a literature search of in vitro/animal studies, clinical studies, systematic reviews and meta-analyses of invasive fungal infections. Females represented 51.2% of invasive candidiasis cases, mostly matching the proportions of females among the general population in the United States and Europe (>51%). In contrast, other IFDs were overrepresented in males, including invasive aspergillosis (51% males), mucormycosis (60%), cryptococcosis (74%), coccidioidomycosis (70%), histoplasmosis (61%) and blastomycosis (66%). Behavioural variations, as well as differences related to biological sex, may only in part explain these findings. Further investigations concerning the association between biological sex/gender and the pathogenesis of IFDs are warranted.

Original languageEnglish (US)
Pages (from-to)599-612
Number of pages14
Issue number6
StatePublished - Jun 2022
Externally publishedYes


  • animal model
  • immunity
  • invasive fungal diseases
  • sex characteristics

ASJC Scopus subject areas

  • Dermatology
  • Infectious Diseases


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