Objective: To analyze the outcomes of seven-year mycology studies of lung cavities contents of pulmonary tuberculosis (TB) patients. Methods: Microscopy and culture (Sabouraud medium with chloramphenicol) of samples from lung cavities (aspirates, materials of biopsies and resections); species identification of isolated strains of yeasts (morphological properties on chromogenic media: CandiSelect® 4, Bio-Rad Labs. and chromID® Candida, bioMí©rieux; biochemical properties: Auxacolor® 2 test-system, Bio-Rad Labs.) and mycelial fungi (conventional methods, identification media: Czapek-Dox and potato dextrose agar). Results: In 2002-2009 we studied samples from lung cavities (caverns, tuberculomas, cysts, aspergillomas) of 264 pulmonary TB patients. Cultural studies revealed fungi in 59 patients. The isolated strains belonged to 18 species of 9 genera: yeasts - Candida (4 species), Geotrichum (1); mycelial fungi - Alternaria (1), Aspergillus (6), Cladosporium (1), Fusarium (1), Paecilomyces (1), Penicillium (2), Rhizopus (1). The fungi from the genus Aspergillus were found in lung cavities of 36 patients: A. fumigatus - in 23 patients, A. flavus - in 3, A. niger - in 4, A. restrictus - in 2, A. terreus - in 3, A. versicolor - in 1. The fungi from the genus Candida were found in 10 patients: C. albicans - in 5 patients, C. glabrata - in 3, C. kefyr - in 1, C. tropicalis - in 1. It is important to note, that the fungi isolated from lung cavities of 21 out of 59 (35.6%) patients were also revealed from bronchoalveolar lavage fluid (BAL) and/or sputum. Conclusions: Lung cavities in TB patients represent an essential risk factor for opportunistic pulmonary mycosis. Development of secondary pulmonary aspergillosis (aspergilloma, other forms of pulmonary aspergillosis) is very likely in such patients. If fungi are found in a lung cavity, it is advisable to perform additional mycology studies of sputum and BAL.
Full conference title:
20th European Congress of Clinical Microbiology and Infectious Diseases
- ECCMID 20th (2010)