A Study on Fungal Infection in Post Pulmonary Tuberculosis

Background: In pulmonary tuberculosis study of fungal diseases attained importance because not only prolonged use of antibiotics is required to treat this disease but also, tuberculosis leaves residual lesions which form fungal super infection. By the presence of cavities and necrotic tissue which favor colonization of fungi and whether this super infection with fungi is responsible for persistent morbidity and symptomatic state even after completion of chemotherapy. This study aims to determine the prevalence and pattern of fungal diseases in patients who completed antitubercular therapy and has sequalae of the disease particularly cavities. Aims: To study the various fungi that can be isolated in sputum of patients who had pulmonary tuberculosis and who had taken anti tubercular drugs. Objectives: 1) Isolation of various fungi and its association with variables like type of disease, age, sex, presence of cavities. 2). Clinical significance of fungi thus isolated in regard to secondary mycotic disease. Materials and Methods: This is a prospective observational study conducted from may 2023 to April 2024 at Department of pulmonary medicine, Kurnool medical college and government general hospital, Kurnool. A total of 100 patients satisfying the inclusion and exclusion criteria were included in the study. Results: The study group consists of 100 patients among which 74(74%) are males and 26(26%) are females. Most common symptoms was cough with or without expectoration followed by wheeze, hemoptysis, SOB.Most common radiological findings were cavity (62%), followed by fibrosis and fibro-cavitary disease.Fungal isolation was more common in patients with disease duration 1 to 2(49%) years and 2-4(47%) years. More no. of cases seen within 4 years of disease duration.It is observed that in 43% of patients the interval between completion of chemotherapy and symptom onset is 1-2 years.Fungal isolation is more common in patients with diabetes mellitus than in patients without diabetes.It was observed that candida alone is isolated from 15% of cases and Asperigillus alone from 34%. No fungus isolated in 51% of cases. Conclusion: The occurrence of fungal infections in treated pulmonary Tuberculosis cases poses a significant challenge with occurrence of dreaded symptoms like hemoptysis that can pose danger. This study helps in determining the prevalence of these infections and the most common fungal species isolated there by guiding the management.