The Percentage of Respiratory Fungal Co-infection in Pulmonary TB Infected Patients

Abstract

Pulmonary tuberculosis (TB) has long been associated with opportunistic fungal infections and could prove lethal if these fungal infections are not detected in the early stages of tuberculosis. This is cross-sectional study conducted on 104 patients who were admitted to ward or ICU in Kobry El Qobba chest hospital. The study took a total period of 7 months, from August 2024 to February 2025. The study was included patients with confirmed diagnosis of TB. CT chest was done and sputum samples were incubated on specialized fungal media (Sabouraud dextrose agar) at 25°C and 37°C for up to 7 days to grow the fungus for identification. Out of 104 patients with pulmonary tuberculosis, 53 (51%) had respiratory fungal co-infection and 51 (49%) did not. Patients with co-infection were older on average (53 ± 21 vs. 47 ± 14 years) and more often male (58% vs. 47%). Hemoptysis was markedly more frequent in co-infected patients (42% vs. 14%). Radiological differences were striking: fibrosis with calcification was common in non-fungal patients (51% vs. 4%), while nodules (60% vs. 14%) and cavities (36% vs. 16%) were strongly associated with fungal infection. Statistical analysis identified several positive predictors of fungal co-infection: hemoptysis (OR = 8.38, p = 0.008), radiological nodules (OR = 6.24, p = 0.04), and advancing age (OR = 1.036 per year, p = 0.043). In contrast, negative associations were observed for fibrosis with calcification (OR = 0.02, p = 0.0015) both linked to reduced odds of fungal infection.