Jitendra Sharma
S M S Medical College, India
Title: Clinical, radiological and microbiological profile of pulmonary aspergillosis in treated cases of pulmonary tuberculosis
Biography
Biography: Jitendra Sharma
Abstract
Introduction & Aim: Pulmonary aspergillosis continues to be one of the serious morbidity seen in clinical practice in patients with inactive pulmonary tuberculosis. There are very few studies regarding this. The present study conducted for detailed spectrum of aspergillosis in treated pulmonary tuberculosis patients.
Materials & Methods: This study is a hospital based observational study. In this study treated patients of pulmonary tuberculosis having symptoms of persistent cough and/or hemoptysis were enrolled after exclusion of active tuberculosis. Sputum for ZN stain, BACTEC culture for mycobacterium tuberculosis, fungal KOH and culture was done. Study duration was total of 18 months. Demographic details, predisposing factors and clinical findings were noted. X-ray and CT chest was done in all patients. FOB was done only in two patients (dry cough but CT suggested aspergilloma). Sample size after exclusions was of 70 patients whose sputum/bronchial wash showed isolation of Aspergillus.
Results: Presentation of pulmonary aspergillosis in treated cases of tuberculosis was most commonly aspergilloma, found in 57% of patients followed by CNPA that was detected in 36% patients and least common was ABPA found in only 7% of patients. Most common symptom was recurrent hemoptysis (73%). Most of the patients were farmers but no significant co morbid illness was seen. Most common species came out to be Aspergillus fumigatus.
Conclusion: Aspergillus is a common fungus growing on dead leaves, stored grain, bird droppings and compost piles. Many cavitary lung diseases are complicated by aspergilloma including TB, silicosis, bronchiectasis, etc. Presentation may vary from aspergilloma, chronic necrotizing pulmonary aspergillosis to ABPA in treated pulmonary TB patients.