Pulmonary mycosis in asthma-chronic obstructive pulmonary disease overlap syndrome

Abstract

Background: Chronic obstructive pulmonary disease (COPD) and asthma are the two most commonly seen obstructive airway disorders, affecting millions of people across the world. Asthma-chronic obstructive pulmonary disease overlap syndrome (ACOS) includes the patients having features of both COPD and asthma. Objectives: The objectives of the study were to evaluate spectrum of fungal infection in sputum/induced sputum/bronchoalveolar lavage (BAL) samples of ACOS patients. Materials and Methods: Our prospective study conducted on 80 patients diagnosed ACOS, in exacerbation, of either sex attending the Department of Respiratory Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, after taking permission from the ethical committee. Sputum or induced sputum or BAL sample was collected in sterile vials and sent to the microbiology department for the examination for fungal species. In microbiology, sputum/BAL samples were subjected to direct microscopic examination using KOH and cultured on Sabouraud Dextrose Agar. The culture was observed daily until 21 days for any fungal growth. Results: Out of 80 patients of ACOS, 43 were males and 37 were females. Culture results were positive for fungal species in 33 patients out of 80 patients (41.2%). Different species of fungi were cultured such as Candida (22.6%), Aspergillus flavus (5%), Aspergillus fumigatus (2.5%), Aspergillus niger (2.5%), Penicillium non-marneffei (3.8%), Trichosporon spp. (3.8%), and Geotrichum spp. (1.3%). Conclusion: Our observations show that a wide spectrum of fungal species is prevalent in respiratory tract in ACOS patients. Determination of pulmonary mycosis in ACOS is required to detect, and treat the coinfection with fungus well in time and decrease morbidity and mortality due to ACOS.