Background

Pulmonary mycoses resemble clinically and radiologically chronic pulmonary tuberculosis. Studies describing the prevalence, etiology and clinical features of pulmonary mycosis are of crucial importance in the Brazilian Amazon.

Aims

To estimate the frequency of pulmonary mycoses in smear-negative tuberculosis patients; to describe their demographic, epidemiological, and clinical characteristics; and to evaluate diagnostic methods.

Methods

A cross-sectional study was conducted at two tuberculosis reference institutions in Amazonas, Brazil. We included 213 patients and collected clinical data, blood and induced sputum to perform serological, direct microscopy, microbiologic culture and PCR-based assays to identify infections caused by Aspergillus fumigatus, Paracoccidioides brasiliensis, Histoplasma capsulatum, Cryptococcus, and HIV. Chest computed tomography was also performed.

Results

Pulmonary mycoses were diagnosed in 7% (15/213) of the cases, comprising ten aspergillosis cases, three cases of paracoccidioidomycosis and one case each of histoplasmosis and cryptococcosis. Among the patients with pulmonary mycoses, 86.7% were former tuberculosis patients. The most significant clinical characteristics associated with pulmonary mycoses were cavity-shaped lung injuries, prolonged chronic cough and hemoptysis.

Conclusions

Our study confirmed the high prevalence of pulmonary mycoses in smear-negative tuberculosis patients in the Brazilian Amazon.

中文翻译：

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巴西亚马逊地区疑似肺结核涂片阴性患者的肺真菌病患病率

背景

肺真菌病在临床和放射学上类似于慢性肺结核。描述肺真菌病患病率、病因和临床特征的研究在巴西亚马逊地区至关重要。

宗旨

估计涂阴肺结核患者肺真菌病的发生率；描述他们的人口统计学、流行病学和临床特征；并评估诊断方法。

方法

在巴西亚马孙的两个结核病参考机构进行了一项横断面研究。我们纳入了 213 名患者并收集了临床数据、血液和诱导痰，以进行血清学、直接显微镜检查、微生物培养和基于 PCR 的检测，以确定由烟曲霉、巴西副球孢子菌、荚膜组织胞浆菌、隐球菌和 HIV 引起的感染。还进行了胸部计算机断层扫描。

结果

在 7% (15/213) 的病例中诊断出肺真菌病，包括 10 例曲霉病、3 例副球孢子菌病和 1 例组织胞浆菌病和隐球菌病。在肺真菌病患者中，86.7% 为既往结核病患者。与肺真菌病相关的最显着临床特征是空腔状肺损伤、长期慢性咳嗽和咯血。

结论

我们的研究证实了巴西亚马逊地区涂阴肺结核患者肺真菌病的高患病率。