Prevalence Of Fungal Infection Research Articles

Isolation and morphological identification of fungi from endometrial samples of postpartum dairy cows

Numerous studies on endometritis of postpartum dairy cows describe the bacterial aetiology of the condition. However, studies on fungal agents causing inflammatory conditions of the reproductive tract are limited. The objective of the present study was to identify the mycotic isolates from the reproductive tract of postpartum dairy cows and analyse their susceptibility to antifungal agents. In this study, 70 endometrial cytobrush samples were collected from dairy cows 40 - 120 days postpartum (dpp) and cultured in Sabouraud dextrose agar (SDA). The isolated fungal cultures were identified by Lactophenol Cotton Blue staining and were subjected to antifungal susceptibility testing. The frequency of isolation of fungi from endometrial samples was 15.71 per cent (11/70). Aspergillus niger was isolated from four (33.33%) samples, followed by Penicillium spp. (25%), Aspergillus fumigatus (16.67%), Mucor spp. (16.67%) and Absidia spp. (8.33%). Antifungal susceptibility testing revealed that 50 per cent of the isolates were susceptible to fluconazole, whereas only 25 per cent of the isolates were completely resistant to amphotericin-B. The prevalence of fungal infection in reproductive tract was higher in cows with an age of ≥ 5 years and a parity of ≥ 2, though this was not significant. A significantly higher number of cattle with history of intrauterine antibiotic therapy were positive for fungal culture. However, the association between prevalence of fungi and reproductive complications was statistically non-significant. Keywords: Postpartum dairy cows, fungal infections, Aspergillus niger, mycotic infections

Increased prevalence of fungemia in Medina, Saudi Arabia.

The prevalence of fungal infection is increasing globally due to an increase in the immunocompromised and aging population. We investigated epidemiological changes in fungemia in one of the major centers in Medina over seven years period with 87,447 admissions. Retrospective search of records for causative agents of fungemia in inpatients at King Fahad Hospital (KFH) in 2013-2019. Fungal-positive blood cultures, demographic, and treatment data were extracted. A total of 331 fungemia episodes proven by blood culture were identified in 46 patients. The annual prevalence of fungemia increased from 0.072 in 2013 to 1.546 patients per 1,000 in 2019. The mean age of fungemia episodes was 56 years, and 62% of episodes occurred in females. Samples from central blood incubated aerobically yielded the highest fungemia rate, accounting for 55% (n = 182). Among yeast species, Candida parapsilosis was responsible for the highest number of episodes 37% (n = 122), followed by Candida glabrata (32%; n = 107), Candid albicans (29%; n = 94), and Cryptococcus neoformans (1%; n = 4). Among molds, Lichtheimia (Absidia) species was the most common (1%; n = 3). Yeast-like fungi Trichosporion mucoides accounted for (0.003% n = 1). The use of antifungal treatment has increased (96%) over the years (2013-2019). An increase in resistance rate of 2% was found in C. albicans and C. glabrata. The most prevalent comorbidity was renal disease (24.2%). C. parapsilosis was the leading cause of fungemia. The association of renal disease with increased candidemia was alarming. This study is a fundamental resource to establish management policies for fungal infection in the region.

A Study on Prevalence, Profile, and Risk Factors of Developing Fungal Infection in Patients With Diabetic Foot Ulcer

Background: Many chronic nonhealing diabetic foot ulcers (DFUs) with increased rates of amputation are frequently associated with fungal infections. Purpose: To evaluate the prevalence, profile, and risk factors of developing a fungal infection in patients with DFU. Methods: This prospective observational study was carried out from October 2018 to July 2020. All adult patients with DFUs admitted to the surgery ward were recruited. Patients on antifungal therapy or who received such therapy within 6 weeks prior to admission were excluded. Three deep tissue samples were sent for bacterial culture, fungal culture, and histopathological examination of fungal elements. Results: A total of 251 patients were enrolled in the study. Of the 23.3% of patients with positive fungal growth (n = 47/202), 2% (n = 4/202) had pure fungal growth and 21.3% (n = 43/202) had mixed growth with bacteria in their ulcers (ie, non-contaminated samples). A significant association was found between wound grade (P = .027), ulcer duration (P = .028), and positive fungal growth in DFUs. Conclusions: In this study, the prevalence of fungal infection in DFUs was 23.3%; Candida tropicalis (27.08%) was the most common isolate, followed by C. albicans (20.83%). The rate of fungal infections was high in patients with mild diabetic foot infection or DFU of 7 to 14 days’ duration.

Focus on Hyperparasites: Biotic and Abiotic Traits Affecting the Prevalence of Parasitic Microfungi on Bat Ectoparasites

The tritrophic association of bats, bat flies, and Laboulbeniales microfungi is a remarkably understudied system that may reveal patterns applicable to community ecology theory of (hyper)parasites. Laboulbeniales are biotrophic microfungi, exclusively associated with arthropods, with several species that are specialized on bat flies, which themselves are permanent ectoparasites of bats. Several hypotheses were tested on biotic and abiotic traits that may influence the presence and prevalence of hyperparasitic Laboulbeniales fungi on bat flies, based on southeastern European data. We found a wide distribution of fungal infection on bat flies, with underground-dwelling bats hosting more Laboulbeniales-infected flies compared to crevice-dwelling species. Bat host behavior, sociality, roost selection (underground versus crevice), bat fly sex, and season all have significant effects on the prevalence of fungal infection. Laboulbeniales infections are more common on bat flies that are infecting bat species with dense and long-lasting colonies (Miniopterus schreibersii, Myotis myotis, Myotis blythii), which roost primarily in underground sites. Inside these sites, elevated temperature and humidity may enhance the development and transmission of Laboulbeniales fungi. Sexual differences in bat hosts’ behavior also have an effect on fungal infection risk, with densely roosting female bat hosts harboring more Laboulbeniales-infected bat flies.

Fungal Infections among Teledermatology Consultations in Dermatology Department of a Tertiary Care Hospital: A Descriptive Cross-sectional Study.

Teledermatology provides virtual consultation to patients using telecommunication technology. Using this method dermatologists can diagnose a condition with the help of pictures of the lesions and short history. During the COVID-19 pandemic, practicing this method has become more relevant. Providing teleconsultations to patients with fungal skin infections can prevent inadvertent use of topical corticosteroids. The objective of this study was to find the prevalence of fungal infections among teledermatology consultations done in a tertiary care hospital. It was a descriptive cross-sectional study where the store and forward and real-time methods were used between February 2020 to July 2020. Ethical clearance was taken from the institutional review board (reference number: 245). Data of those patients who wanted consultations from this department were sent by medical officers deployed in military hospitals that are under the central army hospital located in Kathmandu. Convenient sampling was used. The collected data was entered and analyzed in the Statistical Package of Social Sciences version 20. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. A total of 451 (33.45%) (30.93-35.97 at 95% Confidence Interval) were diagnosed with fungal infections out of 1348 patients who were enrolled for the study. About 361 (80%) of the patients suffering from fungal infections belonged to the Terai region and 90 (20%) belonged to mountainous areas. The prevalence of fungal infection among teledermatology consultation was lower than the findings from a similar international study.

Diversity and prevalence of entomopathogenic fungi (Ascomycota, Hypocreales) in epidemic populations of bark beetles (Coleoptera, Scolytinae) in spruce forests of the Tatra National Park in Slovakia

Bark beetles are serious forest pests in Slovakia. Their outbreaks may have significant ecological and economic impacts on spruce forests. There is a variety of natural enemies that activate themselves during population outbreaks of insects and entomopathogenic fungi belong to important antagonists with a potential to regulate populations of their hosts. In 2014–2016, species richness and prevalence of entomopathogenic fungi were evaluated during the bark beetle outbreaks in spruce forests affected by windstorms in the Tatra National Park in Slovakia. Three Beauveria species, B. bassiana, B. caledonica and B. pseudobassiana, with Metapochonia bulbillosa were identified from 271 specimens of three bark beetle species, Ips typographus, Ips amitinus and Pityogenes chalcographus. Beauveria bassiana was the dominant pathogen and infected all three bark beetle species. Phylogenetic analysis identified three phylogenetic groups of B. bassiana in the evaluated host populations. M. bulbillosa was reported for the first time from bark beetle hosts and Slovakia. The prevalence of fungal infection in natural populations of I. typographus was low, varied between 0.07 and 0.72%, and have little influence on the bark beetle abundance.

Diversity and prevalence of entomopathogenic fungi (Ascomycota, Hypocreales) in epidemic populations of bark beetles (Coleoptera, Scolytinae) in spruce forests of the Tatra National Park in Slovakia

Bark beetles are serious pests for forestry in Slovakia. Their outbreaks may have significant ecological and economic impacts on spruce forests. Effective control of bark beetles is difficult due to their cryptic habits, however, microbial control using entomopathogenic fungi is believed to be a promising alternative to traditional control measures. During 2014–2015, diversity and prevalence of entomopathogenic fungi was studied in populations of bark beetles infesting spruce forests affected by windstorms in the Tatra National Park in Slovakia. Three Beauveria species, B. bassiana , B. caledonica and B. pseudobassiana , together with Metapochonia bulbillosa were identified from 271 specimens of three bark beetle species, Ips typographus , Ips amitinus and Pityogenes chalcographus . Beauveria bassiana was the predominant pathogen and infected all three bark beetle species. Phylogenetic analysis identified three phylogenetic groups of B. bassiana in the evaluated host populations. M. bulbillosa was reported for the first time from bark beetle hosts and Slovakia. The prevalence of fungal infection in natural populations of I. typographus was low and varied between 0.07 and 0.72%.

Diagnostic value of serum human Galactomannan aspergillus antigen and 1,3-beta-D-glucan in immunocompromised patient suspected fungal infection.

BackgroundThe prevalence of fungal infection (FI) in developing countries is high, but the diagnosis of FI is still challenging to determine, so it is needed evaluation of biomarkers other than microbiological culture, because the culture has low sensitivity, high cost, not available in every laboratory and needs a long time. The detection of human galactomannan Aspergillus antigen (GAL) and 1,3‐beta‐D‐glucan (BDG) on the fungal cell wall could be the promising biomarkers for fungal infection. Neutropenia, lymphopenia and CD4T cells in the immunocompromised patients are essential factors, but these cell associations with BDG and GAL levels have not been evaluated yet. The study aimed to evaluate GAL and BDG for detecting fungal infection and their association with total leucocyte count, neutrophil, monocyte, lymphocyte and CD4T cells.MethodA cross‐sectional study was conducted among 86 patient with suspected FI. Fungal infection established using EORTC/MSG criteria. Serology test performed using ELISA. Leucocyte cells were measured using a haematology autoanalyser, and CD4T cells were analysed using BD FACSPresto. Statistical analysis obtained using Spearman's correlation coefficient, ROC curve analysis and 2 × 2 contingency table.ResultsSerum Galactomannan and BDG had a significant correlation with CD4T cells and total lymphocyte count (p < 0.05). The cut‐off OD GAL >0.3 had sensitivity 54.6%, specificity 87.5% and AUC 0.71; meanwhile, the BDG cut‐off >115.78 pg/ mL had sensitivity 71.2%, specificity 52.4% and AUC 0.63 for detecting fungal infection.ConclusionsThe immunocompromised patients can undergo GAL for determining the diagnose of FI. The lower the CD4T cells and total lymphocyte count, the higher the GAL and BDG serum levels.

Fungal Infection among Diabetic and Nondiabetic Individuals in Nepal.

Background Low immunity, comorbid clinical conditions, and metabolic disorders may be the underlying factors that determine the severity of infection. Diabetes increases the risk of infection and multiple organ damage. In Nepal, the actual burden of fungal infections has not been estimated or is in a limited progress. This study aimed to investigate the status of fungal infection in diabetic and nondiabetic individuals in Bhaktapur, Nepal. Materials and Methods A total of 670 samples were collected from 134 participants. From each participant, five samples were collected from different sites like an oral wash, toe swab, midstream urine, hair shaft, and nail scrapings. All samples were cultured on Sabouraud dextrose agar. Gram stain was used to observe yeast cells and lactophenol cotton blue stain was used for hyphae. Chlamydospore production by Candida species was observed in cornmeal agar medium by Dalmau Plate method. Candida species isolated were characterized by germ-tube test and differentiated using CHROM agar Candida medium. Candida species isolates were tested for antibiotic susceptibility. Results Overall, 19.4% of the samples showed fungal growth. The prevalence of fungal infection was higher in diabetic (34.0%) than nondiabetic individuals (4.7%). Fungal growth was found to be higher in oral wash followed by toe, urine, hair, and nail samples. Predominant fungi were Candida species (57.5%), Aspergillus species (28.4%), and Trichophyton species (10.7%). Oral wash, toe, and urine samples in diabetics had a significantly higher fungal prevalence when compared between both groups, p value < 0.05. In Candida isolates, higher resistance was seen against fluconazole 36.8% and ketoconazole 28.9%, whereas other drugs showed low resistance. Conclusion Diabetic participants are more susceptible to fungal infection than the nondiabetics. Overall, Candida species and Aspergillus species are highly predominant fungi. Candida species are highly resistant to fluconazole and ketoconazole.

A clinicopathological study on fungal infection in nasal polyposis

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Nasal polyposis is a multifactorial disease. Despite the presence of numerous theories proposed towards the aetiology of nasal polyp, inflammation is the main causative factor. Fungi can impair the local immune system and bring about an inflammatory response causing polyp formation. The aim and objective of the research was to know the prevalence of fungal infection in nasal polyposis and to assess the microbiological and pathological features of fungi in nasal polyposis.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A total of 100 patients operated for nasal polyposis were included in the study excluding immune-compromised patients. All the nasal polyposis cases were subjected to clinical examination, diagnostic nasal endoscopy and medical treatment before undergoing surgical treatment. Polyps removed were subjected to histopathological examination (HPE) and potassium hydroxide (KOH) wet mount examination under microscope. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Out of the 100 patients studied 66 patients (66%) were in the age group between 31 to 60 years. 85 patients had bilateral polyps, in which fungal element was isolated in 11 patients and among 15 patients with antrochoanal polyp 1 patient had fungal isolates. Of the 17 patients who had previous history of surgery, fungi were isolated in 4 patients and the rest were from patient who got operated for the first time. 3 out of the 8 patients, who had recurrence, were positive for fungal infection.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Fungi are found to be more prevalent in nasal polyps and fungi can be considered as one of the main causative factor for formation of nasal polyposis and its recurrence after surgery. Anti-fungal agents could be a helping hand in the management of nasal polyposis to prevent its recurrence.&lt;/p&gt;&lt;p&gt; &lt;/p&gt;

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English

Fungal infection in surgical pathology - Our institutional experience

Background: Fungal infection has a worldwide prevalence and it affects almost all age groups and both the sexes. Due to neoteric treatment modalities nowadays, people are enjoying longevity of life. However, on the other hand, immune status is compromised that has resulted in increased prevalence of fungal infection in society. Fungi reported by surgical pathologist, either incidentally or in clinically suspicious cases, greatly improve morbidity and outcome of the patients. Objective: The objective of this study is to study the prevalence of fungal infection in surgical pathology tissue and frequency and spectrum-based analysis in relation to age, gender, and systemic involvement. Materials and Methods: Ethically approved retrospective observational secondary data analysis is done based on histomorphological and cytomorphological evaluation of 17 fungal cases diagnosed at the Department of Pathology, New Civil Hospital, Surat, from January 2015 to January 2017. Results: Out of 17 cases, most common fungus seen was Candida albicans mainly affecting gastrointestinal tract. Common age group affected was 41–60 years and few rare fungi, i.e., mucormycosis and tinea corporis were also reported. Conclusion: Distribution of fungi in tissue section in relation to frequency, age, sex, various organs, and its correlation with clinical symptoms is analyzed in our study and results are found to be yielding that provided outlook in the prevalence of infectious agent.

Prevalence of equine ulcerative keratomycosis in Colorado and association of environmental factors: A retrospective and descriptive study (2002–2017)

SummaryEquine ulcerative keratomycosis is relatively commonly presented to teaching hospitals in North America, with a prevalence from 24 to 86%. Horses in Colorado may have lower risk due to the dry mountain climate, but data are lacking. This study aimed to determine the prevalence of ulcerative keratomycosis amongst horses with ulcerative keratitis presented to Colorado State University Veterinary Teaching Hospital (CSU‐VTH) ophthalmology service and to evaluate environmental factors (season, temperature, humidity, wind speed and elevation) associated with ulcerative keratomycosis in Colorado. A database search identified horses with ulcerative keratitis presented to the ophthalmology service at CSU‐VTH from January 2002 to August 2017. Sixty‐one horses met the inclusion criteria of a corneal cytology and/or culture or histopathology at the time of diagnosis; cases lacking that were excluded. Environmental factors at the boarding sites, including season, temperature, humidity, wind speed and elevation and clinical outcomes for fungal cases, were recorded. Prevalence of fungal infection amongst equine ulcerative keratitis was 16.4% (10/61), suggesting that CSU‐VTH has considerably fewer ulcerative keratomycosis cases than other veterinary teaching hospitals in North America. Spring (50%, 5/10) and fall (40%, 4/10) had the highest prevalence of fungal ulcerative keratitis in Colorado. Only one case was reported in summer (10%, 1/10); no horses were positive (0%, 0/10) in winter. Only wind speed seemed to influence the development of ulcerative keratomycosis with higher wind speeds associated with greater rates of fungal involvement (P = 0.047). Other environmental factors did not show a detectable association (all P‐values &gt;0.05). Outcomes were variable. It was concluded that horses from the area of CSU‐VTH appear to be at lower risk for ulcerative keratomycosis than from the areas around other North American veterinary teaching hospitals that have reported data. Most horses with keratomycosis in this area present in the spring and fall.

Epidemiology and Risk Factors of Superficial Fungal Infections in Toukh Primary Health Care Centre

Background: Fungal skin infection has become a significant problem. Therefore accurate diagnosis and treatment of the active disease as well as the reduction of the re-infection by continued screening, follow up of relatives, treating asymptomatic carriers and disinfecting their environment is mandatory. Objective: The study was conducted to determine the frequency of superficial cutaneous fungal infections in Toukh City and to identify the risk factors underlying superficial cutaneous fungal infections. Patients and Methods: Our study investigated prevalence of fungus infections in Toukh Primary Health Care Center, 420 study participants were examined for presence of fungus infection of glabrous skin, hair and nails. All participants completed a questionnaire to estimate their knowledge about superficial fungal infections (SFIs) and to record presence of risk factors for SFIs. Results: The study showed more prevalence of fungal infection (18.6%). Dermatophyte infections were more prevalent than non-dermatophyte (51.2% vs 37.2%) of infected cases. Onychomycosis had prevalence 1.2% of our study participants and 6.4% of infected participants. Candidal infection was (5.2%), tinea (T.) pedis was (3.6%), T. cruris was (2.1%), T. capitis was (1.7%), T. versicolor was (1.7%), T. circinata was (1.2%), T. barbae was (0.5%) and T. corporis was (0.5%) of study participants. Females represent (62.8%) of cases, while males represent (37.2%). Concerning with predisposing factor was contact with animals (70.5%). (57.1%) of infected participants were diabetics, (71.4%) of infected participants were usually wearing synthetic clothes, (64.1%) of infected participants shared towel between family members and (73.1%) shared hair brush. Conclusion: Skin fungal infections are widely prevalent among the population and there is need to increase the awareness of risk factors contributing to skin fungal infections. Awareness in relation to personal hygiene, education status and occupation do play a part in genesis of SFIs.

Prevalence of fungal infection in nasal polyposis in a tertiary care hospital in Karachi (Abbasi Shaheed Hospital) through a cross-sectional study

Prevalence of fungal infection in nasal polyposis in a tertiary care hospital in Karachi (Abbasi Shaheed Hospital) through a cross-sectional study

Systemic Fungal Infections in Donors for Corneal Transplantation.

To determine the prevalence of postkeratoplasty fungal infection when corneal tissue from donors with a recent medical history of oral thrush or respiratory, urine, wound, sputum, bronchial, tracheal, or throat culture positive for fungus is identified before recovery and after decontamination of the corneal tissue with 5% povidone-iodine flush to the donors' eyes during recovery. This is a prospective analysis of corneas from 42 donors with a documented medical history of fungus or positive fungal culture, which were recovered between January 2010 and November 2010. Standard aseptic swab of the donors' corneas before and after application of 5% povidone-iodine solution was performed. Culture results were analyzed in relationship to the donors' medical history and potential posttransplantation infections. Eighty-four eyes from 42 patients were swabbed for cultures during the study period. Seven eyes (8.3%) were positive for fungal growth before treatment with 5% povidone-iodine, whereas there were no positive fungal cultures after treatment (P = 0.007). Fifty-four corneas from this study group were used for corneal transplantation. There were no cases of fungal infection in any postkeratoplasty eyes transplanted from this study group. In this small study, the overall prevalence of fungal infections after corneal transplantation using corneal donor tissue from donors with a fungal-positive medical history is low. Corneal fungal contamination in donors with a history of fungal infection or a positive fungal culture can be significantly reduced with a 5% povidone-iodine flush.

Prevalence of Fungal Infection in Chronic Suppurative Otitis Media-A Study at Tertiary Care Hospital in Western Uttar Pradesh

Background: Chronic otitis media (CSOM) is a notorious infection prevalent mostly in developing countries due to indiscriminate uses of local steroid and antibiotics in the ear either alone or combination. Humidity also plays a major contributing factor in the etiology of otitis media. Objective: To know the prevalence of fungal infection in chronic suppurative otitis media. Method: The study was conducted on 130 cases of recurrent discharging ear at the out patient door of Deptt of E.N.T and Dept. of Microbiology, Rohilkhand Medical College and Hospital, Bareilly. Results: Out of 130 cases, 34 were found fungal positive having the prevalence rate 26.15%. The side of involvement was more common in right ear (66.66%) than left. Males are affected more (58.82%) than females. Most of the fungal infections were associated with the use of local steroid and antibiotics (79.41%). Predominent fungal isolates were Aspergillus spp. (32.35%) followed by other saprophytic fungi (52.94%). Key words: Chronic suppurative otitis media, Fungal infection, Steroid and antibiotics

Wild Animals as Sentinels of Paracoccidioides brasiliensis in the State of Rio Grande do Sul, Brazil

Paracoccidioides brasiliensis, a dimorphic pathogenic fungus, causes the principal form of systemic mycosis in Brazil. The literature furnishes only limited data on the ecology of this fungus in the state of Rio Grande do Sul, the southernmost state of Brazil. The purpose of this study was to evaluate the prevalence of fungal infection in wild animals, using serological tests and using the animals as sentinels of the presence of P. brasiliensis in three specified mesoregions of Rio Grande do Sul. A total of 128 wild animals from the three mesoregions were included in the study. The serum samples were evaluated by immunodiffusion and the enzyme-linked immunosorbent assay (ELISA) technique to detect anti-gp43 antibodies from P. brasiliensis. Two conjugates were tested and compared with the ELISA technique. Although no positive samples were detected by immunodiffusion, 26 animals (20%), belonging to 13 distinct species, were found to be seropositive by the ELISA technique. The seropositive animals were from two mesoregions of the state. The results were similar according to the gender, age, and family of the animals, but differed significantly according to the conjugate used (p < 0.001), showing more sensitivity to protein A-peroxidase than to protein G-peroxidase. The finding that wild animals from the state of Rio Grande do Sul are exposed to P. brasiliensis suggests that the fungus can be found in this region despite the often-rigorous winters, which frequently include below-freezing temperatures.

Epidemiology of Fungal Infections at an Infectious Disease Reference Centre in Malaysia

Introduction: Epidemiology of fungal infections in an infectious disease reference centre is different from other institutions. This study aimed to look at the scenario of fungal infections at an infectious disease reference centre in Malaysia. Methods: All positive fungal cultures from an infectious disease reference centre were identified by routine mycology laboratory methods. Patient demographic, laboratory and clinical data were collected and analyzed. Duplicate data were excluded. Results: Middle-aged Malay males were the most common group. However, increased proportions of Chinese, Myanmar and Indonesians reduced the Malay predominance in HIV-positive group. In all patients, Candida species represented 64.1% isolates, followed by Cryptococcus neoformans (14.7%) and Penicillium marneffei (14.7%). Among HIV[1]positive individuals, C. neoformans (37.9%) was the most common species, followed by P. marneffei (35.6%) and all Candida species (17.2%). In contrast to other non-infectious disease reference centres, common causes of fungaemia included P. marneffei (43.5%), Candida species (25.8%), C. neoformans (24.2%) and H. capsulatum (6.5%). Conclusion: The prevalence of fungal infection at an infectious disease reference centre is different from other non-infectious disease reference centres. This may have an impact on current antifungal practice especially empiric antifungal therapy, patient morbidity and mortality.

The prevalence of fungal infections in unilateral abnormal sinus imaging

Background: Rhinosinusitis is a common disease which may involve paranasal sinuses unilaterally or bilaterally. Bilateral paranasal sinus infection is more prevalent, and mostly caused by viruses, bacteria and fungi respectively. Unilateral rhinosinusitis is found infrequently and is mostly caused by bacteria and fungi. Objectives: We studied the prevalence and types of fungal infection, and types of rhinosinusitis, in patients with unilateral abnormal sinus imaging Method: A descriptive study with prospective data collection from 44 patients with unilateral abnormal sinus imaging, who were diagnosed with rhinosinusitis in Srinagarind hospital, Khon Kaen University, Thailand between August 2005 and August 2007. Results: The prevalence of fungal infection in unilateral rhinosinusitis was 16/41 (39.0 %, 95% CI 24.1-53.9). Bacterial infection was found in 25/41 (61%, 95% CI 46.1-75.9). Three patients were lost to follow-up. Most cases with fungal infection in our study had fungal balls which were removed by endoscopic surgery. Conclusion: A high prevalence of fungal infection was found in patients with unilateral rhinosinusitis. This group of patients who do not respond to antibiotics require further investigations to evaluate fungal infection and early surgical intervention should be considered. Keywords: Fungi, magnetic resonance imaging, radiography, sinusitis, tomography; X-Ray computed