Abstract
Background: The burden of pulmonary mycosis is increasing and often misdiagnosed as pulmonary tuberculosis in developing countries where the prevalence of pulmonary tuberculosis is high. Objective: To determine the prevalence of pulmonary mycosis and pulmonary tuberculosis fungal co-infections. Methods: A hospital-based, cross-sectional study was conducted between October 2019 and May 2019. Sputum was collected from 636 study subjects. Part of the sputum was inoculated onto Brain Heart Infusion agar and fungi were identified following standard microbiological procedures. The remaining part of the sample was used for the investigation of pulmonary tuberculosis by GeneXpert.Results: Among 636 sputum samples, 75.9% (483), 25.6% (163), and 20% (127) were positive for fungal pathogens, pulmonary tuberculosis, and pulmonary tuberculosis fungal co-infection, respectively. Of 690 fungal isolates, 81.4% were yeasts compromising of 46.3% Candida albicans 52.7% Non-albicans Candida species, and 1.0% Cryptococcus neoformans. The remaining 128 (18.6%) isolates were molds, where Aspergillus species (79; 61.7%), Penicillium species (16; 12.5%), Scedosporium apiospermum (13; 10.2%), and Fusarium species (10;7.8%) being the major isolates. The isolation rate of fungi was higher in males (51.6%) than in females (48.4%). There was no statistically significant association between the prevalence of pulmonary fungal pathogens and sex (P=0.239). Patients in the age group of 35-44 and above were slightly more affected than younger age groups. The association of fungal pathogens and age was not statistically significant (P=0.50). Conclusions: Our study revealed a high prevalence of pulmonary fungal pathogens (75.4%) and pulmonary fungal co-infection (20%). The isolation rate of Non-albicans Candida species out-numbered that of C. albicans. High prevalence of pulmonary fungal pathogens in our study, especially in cases where sputum for pulmonary tuberculosis was negative alerts, the need to employ conventional microbiology tests along with clinical and radiological evidence.