Fungal Elements in Sputum Cytology Among Active and Post_Treated Pulmonary Tuberculosis Patients in Al Managil Teaching Hospital, Gezira State, Sudan (2020)
Publication Date: 05/10/2022
Author(s): Hameeda Ibrahim Ahmed Mustafa, Dr. Wad al bahar Hamad alnil Abd allah, Dr. Abd alraheem Ali Babiker.
Volume/Issue: Volume 5 , Issue 2 (2022)
Abstract:
Sputum cytology is still one of the most effective and producible sample for diagnosis and evaluation of lung diseases and disorders. For this, it can used for evaluation of apportunistic fungal pathogens on pulmonary tuberculosis patients, which is of leading cause of death worldwide. On this cross sectional laboratory base study, which used to evaluate the sputum cytology for presence of opportunistic fungal elements. A total 110 early morning expectorate sample collected from the period 1/3 to 30/6/2020. 69/110 (63%) from patients come for first diagnosis to the center of T.B and HIV. Al Managil teaching hospital, and 41/110 (37%) follow-up starting from second month until six month post- treated follow up. From each sample two slides was prepared. One of them fixed immediately before air-drying in 95% ethanol and later stain by PAS technique, the other fixed after air-drying on absolute methanol and stain by Giemsa stain. Regardless to other method of fungal identification such as serology or mycological culture, only depends on microscopic identification. The study found that 95/110 (86%) was negative for fungal elements, and 15(14%) was positive, 9(8%) positive in diagnosis group and 6(5%) in follow-up group. Moreover the most common infectious agents was Candida species 9/110 (8%), 6/110 (5%) present as yeast and 3/110 (2%) as Pseudohyhae. Followed by Aspergillus species 5/110 (4%) then actinomyces species 1/110(.9%). The incidence of infection is higher in rural (82%) males (55%) farmers (36%). In the majority of the pateints with negative results for fungi MDR-TB not detected 87(79%), followed by positive for fungi and also MDR-TB not detected 15 (13.6%), then (negative and positive) for fungi and MDR-TB with high rate with the same percentage 3(2.8%), and finely very low MDR-TB 1(.9%), medium MDR-TB 1(.9%) without any detection of fungal elements. The study recommended including fungal testing and antifungal drugs on the pulmonary TB treatment plan as possible causes of complications.
Keywords:
Pulmonary tuberculosis. Sputum sample. Cytology smear. Fungal elements. Opportunistic infections. Pap stain.
