Rising environmental temperatures and polluted surface waters: the prelude to the rise of mycoses in South Africa

South Africa's rivers are frequently used by communities lacking proper sanitation infrastructure for domestic purposes; however, these surface waters may pose a health risk to immunocompromised individuals due to the presence of opportunistic pathogenic fungi in the polluted water. Although only a few studies have focused on the presence of clinically relevant fungal species in South African rivers, many known opportunistic pathogenic species were found to be predominant in these waters. Furthermore, strong evidence exists that increased numbers of clinically relevant species may be observed in future due to fungi acquiring thermotolerance in response to the global increase in temperature. Thermotolerance is a major factor contributing to pathogenesis in fungi, due to the generally low tolerance of most fungi toward mammalian body temperatures. It is therefore contended that combinatorial effects of water pollution and rising environmental temperatures could lead to an increase in the incidence of mycoses in South Africa.This is especially concerning since a relatively large population of immunocompromised individuals, represented mostly by HIV-infected people, resides in the country.