Department of Veterinary Pathology, Microbiology and Parasitology, Faculty of Veterinary Medicine, University of Nairobi, Nairobi, Kenya.
Department of Medical Services and Public Health, Ministry of Health Laikipia County, Nanyuki, Kenya.
Int J Mycobacteriol. 2020 Apr-Jun;9(2):116-120. doi: 10.4103/ijmy.ijmy_44_20.
Dimorphic fungi may cause infections and symptoms similar to tuberculosis (TB), in humans and animals. Such infections, individually or concurrently with TB, have been identified in cattle in Kenya, raising the possibility of infections in other animals, including humans. The study aimed to identify and quantify dimorphic fungi co-infection in persons with TB.
Smear-positive sputum samples, 400, were obtained from TB clinics between October 2016 and November 2017. The samples were examined microscopically for yeast fungi, cultured for isolation of yeast, conversion to molds, and conversion from molds to yeasts. The isolates were characterized morphologically.
Blastopores, with morphological characteristics of Paracoccidiodes and Blastomyces, were observed in 37 smears of the sputum samples. Similar yeast cells were observed in smears of the sputum cultures. The yeast cultures were converted to molds on incubation at room temperature and back to yeasts on incubation at 37°C.
Dimorphic fungi, morphologically identified as Paracoccidiodes and Blastomyces, concomitantly infect a proportion of TB patients in the study area. It is recommended that routine diagnosis for TB should consider infection or co-infection by dimorphic fungi for institution of appropriate treatment.
二相真菌可引起人类和动物与肺结核（TB）相似的感染和症状。在肯尼亚，牛群中已单独或与结核病同时发现了这些感染，这增加了其他动物（包括人类）感染的可能性。本研究旨在确定和量化结核病患者中二相真菌的合并感染。
2016 年 10 月至 2017 年 11 月期间，从结核病诊所获得了 400 份涂片阳性的痰液样本。对这些样本进行了显微镜检查，以检测酵母真菌，并进行了酵母分离、形态转化和霉菌到酵母的转化培养。对分离物进行了形态学特征描述。
在 37 份痰液样本的涂片上观察到了芽孔，具有副球孢子菌和芽生菌的形态特征。在痰液培养物的涂片上观察到了类似的酵母细胞。在室温孵育时，酵母培养物转化为霉菌，在 37°C 孵育时又转化为酵母。
在研究区域，形态学上鉴定为副球孢子菌和芽生菌的二相真菌同时感染了一部分结核病患者。建议常规的结核病诊断应考虑感染或合并感染二相真菌，并进行适当的治疗。
