الفهرس 
FUNGAL PNEUMONIAOnly 14 pages are availabe for public view
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Abstract
T
he incidence of pulmonary mycosis had increased over the past few decades due to the wide use of broad-spectrum antibiotics, immunosuppressive and chemotherapy agents as well as the increased incidence of respiratory diseases, including chronic obstructive pulmonary disease (COPD), lung cancer and tuberculosis. It has been reported that the overall incidence of systemic fungal infection is up to 11.3% and 60% of them involve the bronchi and lungs at autopsy (Bai-ling et al., 2011).
The studies on pulmonary mycoses and the incidence of infection with specific fungal agents in the context of chronic lung pathology have been relatively limited. Previous studies was concerned mainly with invasive and systemic fungal infections in patients with cancer, organ transplantation, and AIDS (Chugh et al., 1993; Crawford et al., 1993). There is no large-scale study on the incidence, comorbid diseases, microbiological spectra or patient outcome of pulmonary fungal infection (Minamoto et al., 1997).
Thus this prospective cross-sectional analytic study had been designed to study the prevalence of different fungal species in patients with different respiratory diseases in RICUs of different hospitals; Ain Sham University, and Military Hospitals during the period from March 2018 to February 2019.
The study included 60 patients with respiratory diseases at risk for pulmonary fungal infection. most of them were male (76.67%) and female (23.33%). The mean age of these participants was 55 years.
All patients were subjected to the following: History, clinical examination, radiology (Plain chest x-ray and computed tomography of chest when possible), routine laboratory investigations had been done and finally mycological analysis: included direct microscopic examination and culture examination of the collected respiratory samples.
The following results were observed:
40 patients (66.67%) out of 60 patients with respiratory diseases had culture-positive for fungus and 20 patients (33.33%) had culture- negative.
The major fungal species encountered in this study were candida species in 23 cases (57.5 %) followed by Aspergillus species in 17 cases (42.5%). Candida albicans was isolated in (23.33%) of patients followed by aspergillus non fumigatus (18.33%) then candida non albicans (15%) and finally aspergillus fumigatus (10%).
COPD was the commonest disease among patients at risk of pulmonary fungal infection, 29 patients (48.33%) of a total 60 patients, 17 (42.5% out of the positive cases) patients of them had positive culture for fungal infection, 10 (43.48%) of them with candida infection and 7 (41.18%) with aspergillus infection.
Among the different co-morbid diseases, the common associations included diabetes mellitus (DM), liver disease, cardiovascular diseases.
Diabetes mellitus was found to be the commonest co-morbid disease associated with high fungal recovery rates especially candida.
There was significant association between steroid use and incidence of candida infection.
Patients who were on mechanical ventillation showed significant candida recovery rate.
The most frequent radiographic manifestations in patients at risk of pulmonary fungal infection in chest radiograph and CT respectively were hyperinflation (50%, 46.67%).
Normal chest ray and CT chest were found in some patients at risk of pulmonary fungal infections (21.67%, 10%).