Frequency and Pattern of Pulmonary Fungal Infections in Patients with Pulmonary Tuberculosis

Abstract

The present study was designed to find out the frequency and pattern of Pulmonary fungal infections in patients with pulmonary tuberculosis. Two hundred sputum samples were taken of patients with pulmonary tuberculosis. Out of 200 sputum samples, one hundred sputum samples were of freshly diagnosed patients with pulmonary tuberculosis and one hundred Patients on antituberculous drugs for at least three months. Fifty sputum specimens from healthy attendants were also examined as controls. All sputum specimens were examined for fungal hyphae and spores by microscopic examination with 10% potassium hydroxide, lactophenol, cotton blue stain and calcofluor white stain (fluorescent staining). Culture on Saboraud’s medium with chloramphenicol was also used for isolation of fungi from sputum specimens. Out of 200 sputum specimens 32 (16%) were positive for fungal hyphae and spores with 10% potassium hydroxide and lactopherol cotton blue staining. While 54(27%) sputum samples were positive for fungus with calcofluor white staining technique and 68(34%) were positive with culture technique. While no specimen was Positive for fungus by any technique among controls. The positivity was significantly higher among tuberculous patient on treatment as compared with freshly diagnosed patients P<0001), among patients with duration of illness more than one year as compared with less than one year P<O.001), patients with cavitary lesions on X-rays and history of haemoptysis (P<0.001). The most frequent fungal isolate was Candida albicans (n=37) followed by Candida albicans (n=17) and Aspergillus fumigatus (n=12). Based on these findings, it is suggested that sputum specimens of Patients with tuberculosis should be routinely examined for the presence of fungi (especially with cavities and haemoptysis).