Pulmonary aspergillosis as opportunistic mycoses in a cohort of human immunodeficiency virus-infected patients: Report from a tertiary care hospital in North India

  • Ravinder Kaur Department of Microbiology, Lady Hardinge Medical College and Associated Kalawati Saran Children Hospital, New Delhi-110001, India
  • Bhanu Mehra Department of Microbiology, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi-110002, India
  • Megh Singh Dhakad Department of Microbiology, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi-110002, India
  • Ritu Goyal Department of Microbiology, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi-110002, India
  • Richa Dewan Department of Medicine, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi-110002, India
Keywords: Acquired immunodeficiency syndrome, Aspergillus, human immunodeficiency virus, galactomannan, pulmonary

Abstract

Objective: The incidence of pulmonary aspergillosis in human immunodeficiency virus (HIV)-infected persons is rising. This study was designed to determine the prevalence of pulmonary aspergillosis in a cohort of HIV-positive patients (n = 71) presenting with lower respiratory tract infection at a tertiary care medical center in India.
Methods: Sputum samples were collected, and potassium hydroxide mount, cultural characteristics, and lactophenol cotton blue preparations were employed to aid in the identification of Aspergillus species. In addition, serum galactomannan antigen testing was also performed.
Results: Pulmonary aspergillosis was diagnosed in 7 patients, five of whom showed a positive antigenemia indicating invasive form of disease. The prevalence of pulmonary aspergillosis was highest in individuals 21-40 years of age (13.3%). The gender-wise prevalence of pulmonary aspergillosis was 18.7% and 7.7% in females and males, respectively. The common chest radiographic findings noted in patients with pulmonary aspergillosis included a normal chest radiograph in 3 (42.8%), infiltrates in 2 (28.6%), and pleural effusion in 2 (28.6%). The common Aspergillus species recovered from sputa of these patients were Aspergillus flavus (4; 57.1%); Aspergillus fumigatus (2; 28.6%), and Aspergillus niger (1; 14.3%). A predisposing lung condition in the form of pulmonary tuberculosis was identified in 2; Pneumocystis carinii pneumonia in 2 and a dual tubercular and P. carinii infection in one. The mean CD4 count of these patients was 155.86 ± 119.33 cells/μl (median = 117 cells/μl; range = 18-329 cells/μl).
Conclusion: Our findings suggest that Aspergillus species be considered possible etiological agents in HIV-positive patients with pulmonary infection.

Author Biographies

Ravinder Kaur, Department of Microbiology, Lady Hardinge Medical College and Associated Kalawati Saran Children Hospital, New Delhi-110001, India

Director Professor and Head,

Department of Microbiology

Bhanu Mehra, Department of Microbiology, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi-110002, India

Senior Resident,

Department of Microbiology

Megh Singh Dhakad, Department of Microbiology, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi-110002, India

Research Scholar,

Department of Microbiology

Ritu Goyal, Department of Microbiology, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi-110002, India

Research Associate,

Department of Microbiology

Richa Dewan, Department of Medicine, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi-110002, India

Director Professor,

Department of Medicine
Published
2017-04-09
How to Cite
Kaur, R., Mehra, B., Dhakad, M., Goyal, R., & Dewan, R. (2017, April 9). Pulmonary aspergillosis as opportunistic mycoses in a cohort of human immunodeficiency virus-infected patients: Report from a tertiary care hospital in North India. International Journal of Health Sciences, 11(2). Retrieved from https://ijhs.org.sa/index.php/journal/article/view/1685
Section
Original Paper