Incidence of pulmonary mycoses in patients with acquired immunodeficiency diseases

Abstract

Fungal infections are common complications ofAIDS and pulmonary complications remain a major cause of both morbidity and mortality in immunocompromised 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 amycosis. 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 inAIDS patients on anti retroviral drugs and those not on drugs. A total of 195 sputum samples were obtained from patients diagnosed with full blown Acquired Immune Deficiency Syndrome (AIDS) who had been sick between 6months to 3 yrs with CD4 count less than 200/mm presentingwith cough at theUniversity ofBeninTeachingHospital (UBTH) Edo State. 55 (28.2%) of population studied had been on anti-retroviralmedication,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 stainingwere used to identify opportunistic fungal pathogens. : 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: (19.0%), (9.7%), (9.7%), (9.7%),
(5.6%), spp (7.2%), (4.1%), (3.6%) and 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. and occurred in all age groups. 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 fallwithin 21-45 age group.

Keywords: pulmonarymycoses, incidence,HIV/AIDS, illness