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Year : 2010  |  Volume : 13  |  Issue : 1  |  Page : 78-83

Incidence of pulmonary mycoses in patients with acquired immunedeficiency diseases

Department of Microbiology, University of Benin, Benin City, Edo State, Nigeria

Correspondence Address:
HAS Aluyi
Department of Microbiology, University of Benin, Benin City, Edo State
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Source of Support: None, Conflict of Interest: None

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Background: Fungal infections are common complications of AIDS and pulmonary complications remain a major cause of both morbidity and mortality in immune compromised patients. Such complications can also result in life threatening meningitis and discomforting if not debilitating thrush. The impact of the Acquired Immunodeficiency Syndrome (AIDS) on the incidence of mycoses is difficult to predict but is likely to be substantial. Retrospective studies in Africa and USA have indicated that 58% to 81% of patients with AIDS develop a mycosis. Objectives: The objectives of the study were to determine the prevalence of pulmonary mycosis in AIDS patients with complications of cough, determine if there is any relationship between AIDS and pulmonary mycoses and determine if there is any difference in the prevalence of pulmonary mycoses in AIDS patients on anti retroviral drugs and those not on drugs. Methods: A total of 195 sputum samples were obtained from patients diagnosed with full blown Acquired Immune Deficiency Syndrome (AIDS) who had been sick between 6 months to 3 yrs with CD4 count less than 200/mm 3 presenting with cough at the University of Benin Teaching Hospital (UBTH) Edo State. 55 (28.2%) of population studied had been on anti-retroviral medication, with the remainder on none during the study period. Forty other sputum samples were obtained from apparently healthy (HIV Seronegative) persons also based in Benin City as controls. All subjects were grouped into <20 (3.1%), 20-30 (32.3%), 31-40 (30.3%), 41-50 (17.4%), ≥51(2.1%) age groups. Test and control samples were cultured on Sabouraud Dextrose Agar and Potato Dextrose Agar and incubated at 37° C and room temperatures respectively with daily observation for growth for 2 weeks. Cultural and morphological characteristics, KOH mount and Lactophenol Cotton Blue staining were used to identify opportunistic fungal pathogens. Results: One hundred and forty (71.8%) of test samples yielded fungal pathogens while 55(28.2%) yielded no growth. 3(7.5%) of control samples yielded fungal growth. Fungal organisms isolated were: Candida albicans (19.0%), Candida stellatoidea (9.7%), Cryptococcus neoformans (9.7%), Candida parapsilosis (9.7%), Torulopsis glabrata (5.6%),Mucor spp (7.2%), Penicillium marneffei (4.1%), Rhodotorula rubra (3.6%) and Fusarium spp (3.1%) in that order. All (9) organisms were isolated from patients within 21-30 and 31-40 age groups; 8 organisms from 41-50 age group and 3 organisms each from ≤ 20 and ≥50 age brackets. Candida albicans and Cryptococcus neoformans occurred in all age groups. Conclusion: Findings suggest that routine management (treatment) of pulmonary opportunistic mycoses in AIDS patients should include treatment for Candidiasis and Cryptococcosis for all age groups as well as additional antifungal agents if patients fall within 21-45 age group.

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