Pulmonary colonization by Aspergillus fumigatus and serum specific IgG against this fungus in patients with tuberculosis

Ref ID: 19502

Author:

MT Hedayati1,2*, Y Azimi2, A Doroudinia3, GH Ghandchi3

Author address:

1Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran
2Department of Medical Mycology and Parasitology, Mazandaran University of Medical Sciences, Sari, Iran
3National Research Institute for Tuberculosis and Lung Di

Full conference title:

6th Advances Against Aspergillosis 2014

Abstract:

Purpose:
Aspergillus is a ubiquitous fungus, which causes a wide spectrum of infections including invasive
pulmonary aspergillosis (IPA), depending on the patient’s immune status and underlying lung disease.
Among the Aspergillus spp, A. fumigatus remains the predominant agent of IPA. In patients with a
preexisting lung cavity from a variety of causes, such as pulmonary tuberculosis (TB) Aspergillus
can colonize and grow into the cavity to form a pulmonary aspergilloma. Therefore, we assessed TB
patients for pulmonary colonization with A. fumigatus and specific IgG against this species.
Material and Methods:
During one year, we studied 124 patients with TB at Massih Daneshvari hospital from Tehran, Iran.
Sputum specimens were analyzed by direct microscopic examination (DME) with 20% potassium
hydroxide. These samples were also processed for fungal culture. The clinical and radiological
features or CT-scan report of all patients were recorded. All patients were screened for serum
specific IgG against A. fumigatus, using Aspergillus IgG ELISA Kit (Genesis Diagnostics Ltd,
Cambridgeshire, UK). The results are expressed in U/mL. IgG >12 U/mL was considered as positive
result based on kit manufacturer instruction.
Results:
Out of 124 patients with tuberculosis (66 male, 58 female, age range: 10-91 years), 54 had abnormal
chest radiographic findings. Chest X-ray findings showed that 48 patients (38.7%) exhibited residual
cavities (31 cases in right lobe, 10 in left lobe and 7 in both lung). Round shaped mass lesion was
detected only in 6 patients (6.8%). DME of sputum was positive in 10 patients for septate fungal
hyphae. A. fumigatus was grown from 14 samples of TB patients. Out of 124 TB patients, 55(44.3%)
cases were positive for specific serum IgG against A. fumigatus. There was a significant relationship
between positive culture, DME and serum IgG profile level (Pvalue < 0.05). Totally, three patients (2.4%) met criteria for aspergilloma. Conclusion: Aspergilloma is a rare presentation of pulmonary aspergillosis and is usually incidentally found in immunocompetent patients with underlying lung disease such as TB. Colonization with Aspergillus in preexisting lung cavity produced by TB should be considered as a risk factor for aspergilloma.

Abstract Number: 30

Conference Year: 2014

Link to conference website: http://www.AAA2014.org

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