Clinicopathological characteristics and temporal trends of histopathologically confirmed fungal and parasitic infections in Zunyi, China: a single-center retrospective study, 2014–2026

Fungal and parasitic infections exhibit considerable heterogeneity in their clinicopathological manifestations and geographic distributions. This study aimed to characterize the pathogen spectrum, clinicopathological features, anatomical distribution, and temporal trends of histopathologically confirmed fungal and parasitic infections in Zunyi, Guizhou Province, China. We retrospectively analyzed cases of histopathologically confirmed fungal and parasitic infections diagnosed at the Department of Pathology, Affiliated Hospital of Zunyi Medical University, between January 2014 and August 2026. Data on patient demographics, pathogen types, anatomical sites of infection, and histopathological findings were collected. Temporal trends in annual infection case counts and the proportions of fungal and parasitic infections were assessed using Spearman’s rank correlation analysis. A total of 1,817 cases were included, comprising 1,711 fungal infections (94.2%) and 106 parasitic infections (5.8%). Aspergillus spp. predominated among fungal pathogens, accounting for 1,568 cases (91.6%), with the sinonasal region being the most frequently affected anatomical site (79.3% of fungal infections). Among parasitic infections, 50.0% involved unidentified parasites or cases in which only parasitic eggs were detected, while Paragonimus spp . accounted for 34.9%. Between 2014 and 2026, the annual total number of histopathologically diagnosed infection cases showed no significant temporal trend (ρ = −0.088, P = 0.775). However, the proportion of fungal infections increased significantly (ρ = 0.956, P < 0.001), whereas that of parasitic infections decreased significantly (ρ = −0.614, P = 0.025). Discordance between the initial clinical and final histopathological diagnoses was observed in 153 cases (8.4%). The relative distribution of histopathologically confirmed fungal and parasitic infections in Zunyi changed substantially between 2014 and 2026, characterized by an increasing proportion of fungal infections and a decreasing proportion of parasitic infections. Aspergillus spp. predominated among fungal pathogens, while paragonimiasis was one of the major specifically identified parasitic diseases. Histopathological examination, supplemented by special staining and molecular testing when appropriate, remains important for the differential diagnosis of fungal and parasitic infections, particularly those mimicking tumors or other space-occupying lesions. Not applicable.