Status of pulmonary fungal infections among individuals with clinical signs of pulmonary tuberculosis at a University Teaching Hospital in Southwestern Uganda

Abstract

Background: Pulmonary mycoses are very important diseases of the respiratory tract and are responsible for significant morbidity and mortality rates worldwide. However, less attention has been paid to them. In this study we determined the prevalence of pulmonary mycoses and their aetiological agents among individuals with clinical signs of pulmonary tuberculosis at Mbarara Regional Referral Hospital (MRRH). Method: This was a Laboratory based cross sectional survey in which 113 participants were recruited. Sputum samples were corrected from each study participant. To each sample the following tests were done; Sabouraud Dextrose Agar (SDA) Culture, GeneXpert and Potassium hydroxide (KOH). Fungal growth of filamentous fungi and yeasts were further examined with LPCB and Germ tube respectively. Generated data was analysed using R studio. Results: Out of 113 participants, 80 (70.8%) had pulmonary mycoses whilst those with pulmonary tuberculosis were 5 (4.4%). C. albicans 22.58% and Aspergillus species 17.20%) were the most aetiological agents for pulmonary mycoses identified among others. Of those who were TB GeneXpert positive, 2 (1.77%) of them were co-infected with pulmonary mycoses. We established a prevalence of 57 (71.3%) for PFI, 3 (60.0%) for MTB in HIV sero positive patients and 18 (22.5%) for PFI, 0 (0.00%) for MTB in HIV sero negative patients. On the other hand, 2 (100%) sero positive patients were co-infected with both PFI and MTB. Conclusion: Our findings highlight the medical importance of pulmonary fungal infections among patients suspected for TB. Importantly, the aetiological diversity established here is rich enough to suggest precise examination using different methods. Established scope of aetiological agents is predominated by opportunistic fungi which when superimposed on to certain underlying conditions such as TB, their effects can be fatal. Therefore, this possibility presents a need to employ appropriate strategies for prevention, diagnosis, and management in TB suspects.