Emerging of Mycotic Infection in Patients Infected with Mycobacterium tuberculosis

World Journal of Medical Sciences 01/2008; 3 (2)(3 (2)):74-80.


In 21st century, the load of opportunistic infections will increase tremendously due to increase in
immunocompromising capacity of host particularly in patients suffering from cancer, AIDS and tuberculosis.
Therefore, optimal management of opportunistic fungal infections is indispensable. Tuberculosis patients are
immunocompromsed and they take prolong treatment of antibiotic and vitamins tablets i.e. immunosuppressive
agents hence fungal infection occurs in early stages of infection. But doctors and physicians prescribe only
antibacterial drugs, so patients require for cure more time due to infection of fungus. But some patients are
those whose sputum examination is negative but x-rays reports are positive and persists symptoms of
tuberculosis, in their lungs there are cavities or opacity, which may be due to opportunistic fungal infection.
The present study aims to relate the opportunistic fungal pathogens, their infections and identification of such
fungi that are present in pulmonary tuberculosis patients, which may help in correct diagnosis of these
diseases. Confirmed tuberculosis by sputum examination in ten laboratories of washim district, Maharashtra,
India. Culture characteristic of defferent fungi analysis were done using sputum sample of chronic tuberculosis
patients and symptomatic patients (Non tuberculosis). In our survey in different hospitals and primary health
center of Washim District (Central India) under the Revised National Tuberculosis Control Programmed
(RNTCP) of World Health Organization, 1357 patients of tuberculosis were recorded during June 2002 to
September 2003 by sputum examination in ten laboratories of tuberculosis in Washim district of Maharashtra,
India. These patients were classified age-wise. The maximum patients were recorded between the age of 35 to
45 years and old patients suffering for mycotic infection. Percentage of male patients was more as compared
to female. Highly pulmonary tuberculosis patients 500 out of the 203 patients were suffering from mycotic
infection. The percentage of mycotic infections in pulmonary tuberculosis patients was 46%. Mainly four types
of fungi, i.e. Aspergillus niger, A. fumigatus, Histoplasma capsulatum and Cryptococcus neoformans were
recorded, which causes severe infection in lungs in patients suffering from pulmonary tuberculosis. The
increasing presence of overlapping opportunistic infections in tuberculosis, identification of such fungi that
are present in pulmonary tuberculosis patients. Which may help in correct diagnosis of these diseases.So that
cure rate will be increase
Key words: Opportunistic mycotic infection Pulmonary tuberculosis and lung diseases

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Available from: Sunita Dashrath Bansod, Feb 17, 2014
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    • "The opportunistic fungi are potential pathogens in the immunocompromised patients, those with some pre – existing disease and those with long history of antibiotics (Chugh, 2000).Tuberculosis patients are immunocompromised and they take prolong treatment of antibiotics and vitamins tablets ie immunosuppressive agents, hence fungal infection occurs in early stage of TB infection (Sunita and Rai, 2008). Aspergillus and candida are the classical examples of such fungi were earlier reported from various plants as pathogens, but now they are known to cause disease in human beings (Gupta et al., 2003). "
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    ABSTRACT: The opportunistic fungi are potential pathogens in the immunocompromised patients, those with the pre – existing disease and long history of antibiotics. The study was designed to document the prevalence of TB associated with respiratory mould infections in Dambatta Kano, Nigeria. The study included induced sputum samples from 300 patients with complaints of symptoms suggestive of Tuberculosis (TB) infections. The TB was diagnosed by sputum Ziehl – Neelsen staining technique. Identification of Mould isolates was done by direct microscopy and culture on two sets of SDA and Corn Meal Agar. Of the 300 sputum samples examined, 28(9.3%) patients were positive to AFB microscopy while fourteen different species were isolated from 26(8.7%) patients mainly caused by the genus Aspergillus. A. niger was isolated in 3(1%) of the patients, while A. fumigatus, A. nudilans and A. terreus were isolated from 3(1%), 1(0.3%) and 2(0.6%) patients respectively. Other fungal agents isolated include, Penicillium viridicatum 3(1%), Rhizopus oryzae 3(1%), Rhizomucor pusillus 1(0.3%). The genus Fusarium had the prevalence of 5(1.5%) comprising of F. oxysporum 2(0.6%), F. nivale 2(0.6%) and F. tricinctum 1(0.3%). The genus Trichophyton had a prevalence of 3(1%) consisting of T. concentricum 1(0.3%) and T. rubrum 2(0.6%). The least prevalence of 1(0.3%) was observed in Malbranchea saccardo and Phoma saccardo respectively. Mould and TB co – infection was 5(1.6%) with male patients having 4(1.3%) while females had 1(0.3%) (P = 0.06145). Co – infection of mould and TB exists and the prevalence of array of these mould species is apparently important considering the immunocompromised status and inadequate response to anti – tubercular drugs of these patients.
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    • "Men are more vulnerable to infection than females due to their greater exposure to the surrounding. These results were in agreement with that of Bansod and Rai [11], who observed that fungal infection was higher in male (62.50%) as compared to female (37.5%). They also reported positive correlation between fungal infection and severe toxemia and haemoptysis. "
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    ABSTRACT: Fungal pulmonary infection can be acquired in tuberculosis, immunodeficiency patients, and other chronic diseases. Many physicians missed fungal pulmonary infection because it does not show specific clinical manifestations. The aim was to identify the presence of overlapping fungal infections in tuberculosis patients, using high multiplexing capacity of DNA microarray.Methods The present study was conducted on 50 tuberculosis patients who were subdivided into: Group I consisted of 30 cases of multidrug resistance tuberculosis, Group II consisted of 10 fresh cases and Group III consisted of 10 relapse cases. Morning sputum samples were examined by DNA microarray.ResultsAspergillus spp., was the only fungus detected in 24% of cases, Group I showed the highest percentage (26.6%) with statistically significant difference compared to Group II and III (20%) for each. Aspergillus fumigatus was the predominant spp. identified followed by Aspergillus niger and Aspergillus flavus. Mixed infection was identified in 4 cases in Group I. A statistical significant association between fungal detection and MDR-TB, diabetic patients, smoker, being male, presence of haemoptysis and toxic manifestations, presence of cavitary lesion or abscess and severity of X-ray finding.Conclusion Microarray detection of mycotic infection represents a rapid diagnostic tool helping early diagnosis of fungal co-infection and pulmonary TB. MDR-TB patients carry the risk of higher percentage of fungal infections and more liable for acquiring mixed fungal pathogens. Presence of male sex, smoking, DM and far extent of lesion must attract physicians’ attention for fungal co-infection with pulmonary TB.
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    ABSTRACT: Epidemiology has been defined as the study of the distribution and determinants of disease frequency in human population and interpreting the observations. Epidemiology is a method of making and interpreting observations in biomedical investigations. These investigations deal with groups of people rather than individual cases and usually study both healthy and ill persons. Epidemiological researchers and scientists have a vital role to play in the health care of the entire population. The biostatisticians design the experiments, trials and analyze the data and interpret the facts. Statistical design and technique helps to describe the involvement of complex human phenomena and behavior. The impact of associated factor(s) can be analyzed with the help of simple statistical design and techniques. This paper described the basic concept of statistical research design and techniques used for analysis of data and interpretation of results and also discussed the experimental error and biasness in the epidemiological research investigation.
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