Kaur Ravinder, Mehra Bhanu, Dhakad Megh Singh, Goyal Ritu, Dewan Richa
Department of Microbiology, Lady Hardinge Medical College and Associated Kalawati Saran Children Hospital, New Delhi, India.
Department of Microbiology, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India.
Int J Health Sci (Qassim). 2017 Apr-Jun;11(2):45-50.
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 ( = 71) presenting with lower respiratory tract infection at a tertiary care medical center in India.
Sputum samples were collected, and potassium hydroxide mount, cultural characteristics, and lactophenol cotton blue preparations were employed to aid in the identification of species. In addition, serum galactomannan antigen testing was also performed.
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 species recovered from sputa of these patients were (4; 57.1%); (2; 28.6%), and (1; 14.3%). A predisposing lung condition in the form of pulmonary tuberculosis was identified in 2; pneumonia in 2 and a dual tubercular and 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).
Our findings suggest that species be considered possible etiological agents in HIV-positive patients with pulmonary infection.
人类免疫缺陷病毒（HIV）感染者中肺曲霉病的发病率正在上升。本研究旨在确定印度一家三级医疗中心出现下呼吸道感染的一组HIV阳性患者（n = 71）中肺曲霉病的患病率。
收集痰液样本，采用氢氧化钾涂片、培养特性及乳酚棉蓝制片以辅助鉴定菌种。此外，还进行了血清半乳甘露聚糖抗原检测。
7例患者被诊断为肺曲霉病，其中5例抗原血症呈阳性，提示为侵袭性疾病。肺曲霉病患病率在21 - 40岁个体中最高（13.3%）。肺曲霉病的性别患病率在女性和男性中分别为18.7%和7.7%。肺曲霉病患者常见的胸部X线表现包括3例（42.8%）胸部X线正常、2例（28.6%）浸润影和2例（28.6%）胸腔积液。从这些患者痰液中分离出的常见菌种为烟曲霉（4株；57.1%）；黄曲霉（2株；28.6%）和土曲霉（1株；14.3%）。2例患者存在以肺结核形式的易患肺部疾病；2例为肺炎，1例为结核和曲霉双重感染。这些患者的平均CD4细胞计数为155.86 ± 119.33个/µl（中位数 = 117个/µl；范围 = 18 - 329个/µl）。
我们的研究结果表明，在HIV阳性肺部感染患者中，曲霉属菌种应被视为可能的病原体。
