Abstract
Objective To explore the characteristics of invasive pulmonary fungal disease and the spectrum of pathogens causing invasive pulmonary fungal disease diagnosed by pathological examination using fungal stains. Methods Patients with an invasive pulmonary fungal disease diagnosed by histopathological analysis through the use of fungal stains (including Grocott's methenamine silver and periodic acid-Schiff stains) were included in this study. The clinical records, radiological reports, pathology, and fungal culture results were reviewed. Results Forty-eight invasive pulmonary fungal disease patients diagnosed by histopathological analysis in the Tianjin Haihe Hospital (including 8 cases obtained by pulmonary resection, 35 cases by fiberoptic bronchoscopic biopsy, and 5 cases by percutaneous lung biopsy) were included. There were 24 male and 24 female patients, aged 21–80 years (53 ± 13 years). There were 37 cases of pulmonary aspergillosis, 4 cases of pulmonary cryptococcosis, 2 cases of pulmonary mucormycosis, and 5 in which pathogens were not determined due to limited tissue availability. Among 48 cases, 32 specimens were submitted to fungal culture. No fungus was detected in culture, although 26 cases of fungus infections were diagnosed by histopathological analysis. Only 3 cases were consistent between histopathological and culture results. In 3 cases, the pathogen was identified as Aspergillus spp. by the histopathological analysis, while the contrasting fungal culture results identified Candida albicans. Conclusion Candida albicans pneumonia was rare, while aspergillosis was common in invasive pulmonary fungal disease diagnosed by histopathological analysis. The majority of patients with an invasive pulmonary fungal disease were culture-negative. Although culture can clarify the fungal pathogen species, it has low sensitivity. Pathological examination with fungal stains has its advantages in diagnosing fungal disease; therefore, more attention should be paid to the role of pathological examination in the diagnosis of fungal disease.
Highlights
We identified several species that caused invasive pulmonary fungal disease diagnosed by pathology, namely, Aspergillus spp., Cryptococcus neoformans, and Mucorales. ere were some differences in the morbidity of different fungal species between our study and those of other reports
In a large series of autopsy reports, data of fungal diseases were reviewed and investigated by collecting studies published in PubMed from 2008 to 2013 [3]. is study identified the following species of fungi: Aspergillus spp., Candida albicans, Cryptococcus neoformans, and Mucorales
In a Chinese report, Liu et al [9] have shown the incidence of different pathogens causing invasive pulmonary fungal disease: Aspergillus spp. 39%, Candida albicans 34%, Cryptococcus neoformans 16%, and Mucorales 2%. ese incidences are different from our results
Summary
To explore the characteristics of invasive pulmonary fungal disease and the spectrum of pathogens causing invasive pulmonary fungal disease diagnosed by pathological examination using fungal stains. Patients with an invasive pulmonary fungal disease diagnosed by histopathological analysis through the use of fungal stains (including Grocott’s methenamine silver and periodic acid-Schiff stains) were included in this study. No fungus was detected in culture, 26 cases of fungus infections were diagnosed by histopathological analysis. In 3 cases, the pathogen was identified as Aspergillus spp. by the histopathological analysis, while the contrasting fungal culture results identified Candida albicans. Candida albicans pneumonia was rare, while aspergillosis was common in invasive pulmonary fungal disease diagnosed by histopathological analysis. Fungal culture is the diagnostic golden standard for invasive pulmonary fungal infection It can identify the fungal pathogen species and test for antifungal susceptibility, but its low sensitivity often delays the diagnosis [5, 6]. Data of histopathological findings with fungal stains in invasive pulmonary fungal disease are scarce. is study compared traditional culture and histopathological methods to improve the diagnosis of pulmonary fungal infection
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Schedule a callMore From: The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale
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