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Background:

The coexistance among fungal pathogens and tuberculosis pulmonary is a clinical condition that generally occurs in immunosuppressive patients, however, immunocompetent patients may have this condition less frequently.

Objective:

We report the case of an immunocompetent patient diagnosed with coinfection Mycobacterium tuberculosis and Candida albicans.

Case Description:

22-year-old female patient, previously healthy, who presented an episode of cough, massive hemoptysis and fever.

Clinical findings and diagnosis:

Physical examination was found crakles in left lung. Microbiological testing includes Ziehl Neelsen, culture for mycobacterium, fungal culture in Sabouraud Dextrose Agar medium and serum filamentation. The tests showed Mycobacterium tuberculosis and Candida albicans. Imaging studies included chest radiography, chest CT scan apicograma and high resolution supported the diagnosis.

Treatment and Outcome:

The patient was treated with anti-tuberculosis and anti-fungal treatment with good clinical evolution.

Clinical relevance:

Fungal infection and pulmonary tuberculosis is rare in immunocompetent patients should be suspected in abrupt episodes of hemoptysis.

 

Dilia Mildret Fontalvo, Universidad de Cartagena

Cartagena, Bolívar

Departamento de Postgrado

Doctorado en Medicina Tropical

Universidad de Cartagena

Grupo de investigación UNIMOL

Gustavo Jiménez Borré, Clinica Nuestra Unidad de Cuidados Intensivo Adultos Departamento de Medicina Interna

Departamento de Medicina Interna

Unidad de Cuidados Intensivos

Doris Gómez Camargo, Universidad de Cartagena

Directora Doctorado en Medicina Tropical

Universidad de Cartagena

Grupo de investigación UNIMOL

Neylor Chalavé Jiménez, Clínica Nuestra

Departamento de Medicina Interna

Unidad de Cuidados Intensivos

Javier Bellido Rodríguez, Clínica Nuestra

Departamento de Medicina Interna

Unidad de Cuidados Intensivos

Bernarda Cuadrado Cano, Universidad de Cartagena

Facultad de Medicina

Departamento de Microbiología

Universidad de Cartagena

Shirley Navarro Gómez, Universidad de Cartagena

Doctorado de Medicina Tropical

Universidad de Cartagena

Fontalvo, D. M., Jiménez Borré, G., Gómez Camargo, D., Chalavé Jiménez, N., Bellido Rodríguez, J., Cuadrado Cano, B., & Navarro Gómez, S. (2016). Tuberculosis and pulmonary candidiasis co-infection present in a previously healthy patient. Colombia Medica, 47(2), 105–8. https://doi.org/10.25100/cm.v47i2.2271

WHO . Global Tuberculosis Report 2015. Geneva: World Health Organization; 2015. http://apps.who.int/iris/bitstream/10665/191102/1/9789241565059_eng.pdf

Ministerio de Salud y Protección Social . Guía de atención de la tuberculosis pulmonar y extrapulmonar. Bogota: Ministerio de la Protección Social; 2014.

Chen X, Gao Y, Zhang Y. Tuberculosis infection might increase the risk of invasive candidiasis in an immunocompetent patient. Rev Inst Med Trop Sao Paulo. 2015;57(3):273–275.

Fridkin SK. The changing face of fungal infections in health care settings. Clin Infect Dis. 2005;41:1455–1460.

Kali A, Charles MP, Noyal MJ, Sivaraman U, Kumar S, Easow JM. Prevalence of Candida co-infection in patients with pulmonary tuberculosis. Australas Med J. 2013;6(8):387–391.

Phukan AC, Sarmabordoloi JN, Mahanta J. Bronchopulmonary candidiasis in a tertiary referral hospital of Assam, India. Indian J Med Sci. 2000;54:491–494.

Naz SA, Tariq P. Study of the trend in prevalence of opportunistic Candidal coinfections among patients of pulmonary tuberculosis. Pak J Bot. 2004;36:857–862.

Vargas-Montiel, Vargas-Camino N, Molero M. Candida in biological human samples. Rev Invest Clin. 1999;40:245–255.

Santiwongkarn P, Kachonboon S, Thanyasrisung P, Matangkasombut O. Prevalence of oral Candida carriage in Thai adolescents. J Investig Clin Dent. 2012;3:51–55.

Kahanpaa A. Bronchopulmonary occurrence of fungi in adults, especially according to cultivation material. Acta Pathol Microbiol Scand B Microbiol Immunol. 1972;227:1–147.

Vázquez J, Sobel J. Mucosal candidiasis. Infect Dis Clin North Am. 2002;16:793–820.

Unis G, Picon P, Severo L. Coexistence of intracavitary fungal colonization (fungus ball) and active tuberculosis. J Bras Pneumol. 2005;31(2):139–143.

Caliskan T, Ozkisa T, Aribal S. High resolution computed tomography findings in smear- negative pulmonary tuberculosis patients according to their culture status. J Thorac Dis. 2014;6(6):706–712.

De Almeida LA, Flores BM, Alves MF, Bombarda S, de Felice SA, Calore EE. Computed tomography findings of pulmonary tuberculosis in adult AIDS patients. Radiol Bras. 2011;44(1):13–19.

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Received 2016-03-13
Accepted 2016-06-07
Published 2016-06-20