PCR-based study of invasive fungal infection in king chulalongkorn memorial hospital: an autopsy analysis

Abstract

Background Invasive fungal infection is a fatal disease. To date, however, there have been very few reports of this infection in Thailand. To our knowledge, this is the first autopsy study using PCR technique for detection of fungal species in Thailand. Method The samples were retrieved from autopsy files of the Department of Pathology, Faculty of Medicine, Chulalongkorn University, during January 2005 to December 2012. The tissue samples containing fungal organisms from patients with invasive fungal infection were submitted for PCR study. The clinicopathological information was also analyzed. Result From the total number of autopsies done during this period (476 cases), there were 39 cases having invasive fungal infection (8.19%). Aspergillus spp. was the most frequent organisms (55.26%) in our series, followed by Candida spp. (23.68%). The two most common species were Aspergillus fumigatus (23.68%) and Aspergillus flavus (21.05%). Almost all cases were immunocompromised patients. Most cases with invasive fungal infection (51.28%) had been on corticosteroid, had underlying hematologic diseases (28.21%) or undergone chemotherapy (25.64%). Conclusion Although invasive fungal infection comprises less than 10% of the autopsy cases in this study, it is extremely common among the immunocompromised individuals, especially those who received corticosteroid and chemotherapy. The most common causative organism is Aspergillus spp.; therefore, clinicians should be aware of this infection in patients with immunodeficiency. Invasive fungal infection is a fatal disease. To date, however, there have been very few reports of this infection in Thailand. To our knowledge, this is the first autopsy study using PCR technique for detection of fungal species in Thailand. The samples were retrieved from autopsy files of the Department of Pathology, Faculty of Medicine, Chulalongkorn University, during January 2005 to December 2012. The tissue samples containing fungal organisms from patients with invasive fungal infection were submitted for PCR study. The clinicopathological information was also analyzed. From the total number of autopsies done during this period (476 cases), there were 39 cases having invasive fungal infection (8.19%). Aspergillus spp. was the most frequent organisms (55.26%) in our series, followed by Candida spp. (23.68%). The two most common species were Aspergillus fumigatus (23.68%) and Aspergillus flavus (21.05%). Almost all cases were immunocompromised patients. Most cases with invasive fungal infection (51.28%) had been on corticosteroid, had underlying hematologic diseases (28.21%) or undergone chemotherapy (25.64%). Although invasive fungal infection comprises less than 10% of the autopsy cases in this study, it is extremely common among the immunocompromised individuals, especially those who received corticosteroid and chemotherapy. The most common causative organism is Aspergillus spp.; therefore, clinicians should be aware of this infection in patients with immunodeficiency.