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Case Reports
. 2016 Jun 30;47(2):105-8.

Tuberculosis and pulmonary candidiasis co-infection present in a previously healthy patient

Dilia Mildret Fontalvo  1 , Gustavo Jiménez Borré  2 , Doris Gómez Camargo  1 , Neylor Chalavé Jiménez  2 , Javier Bellido Rodríguez  2 , Bernarda Cuadrado Cano  3 , Shirley Navarro Gómez  3
Affiliations
Case Reports

Tuberculosis and pulmonary candidiasis co-infection present in a previously healthy patient

Dilia Mildret Fontalvo et al. Colomb Med (Cali). .

Abstract
in English, Spanish

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: A female patient, who is a 22-years old, with fever and a new onset of hemoptysis.

Clinical findings and diagnosis: Diminished vesicular breath sounds in the apical region and basal crackling rales in the left lung base were found in the physical examination. Microbiological tests include: chest radiography and CAT scan pictograms in high resolution, Ziehl-Neelsen stain, growth medium for fungus and mycobacteria through Sabouraudís agar method with D-glucose. Medical examinations showed Candida albicans fungus and Mycobacterium tuberculosis present in the patient.

Treatment and outcome: Patient was treated with anti-tuberculosis and anti-fungal medications, which produced good responses.

Clinical relevance: Pulmonary tuberculosis and fungal co-infection are not common in immunocompetent patients. However, we can suspect that there is a presence of these diseases by detecting new onset of hemoptysis in patients.

Antecedentes: La coexistencia entre los hongos patógenos y la tuberculosis pulmonar es una condición clínica que se produce generalmente en pacientes inmunosuprimidos, sin embargo, los pacientes inmunocompetentes puede tener esta condición con menor frecuencia.

Objetivo: Presentamos el caso de un paciente inmunocompetente con diagnóstico de una coinfección de tuberculosis Mycobacterium tuberculosis y Candida albicans.

Caso clínico: Paciente femenina de 22 años con cuadro abrupto de tos, fiebre y hemoptisis sin antecedentes de enfermedad.

Hallazgos clínicos y métodos diagnósticos: Al examen respiratorio se halló disminución del murmullo vesicular en la región apical y estertores crepitantes basales en el pulmón izquierdo. Se realizó estudios microbiológicos de muestras tomadas por expectoración y por fibrobroncoscopia en el que se incluyó la tinción de Ziehl-Neelsen, cultivo para micobacteria y hongos en medio Agar Dextrosa Sabouraud y filamentización en suero obteniéndose positividad para Mycobacterium tuberculosis y Candida albicans.

Tratamiento y resultado: Se le realizó manejo con antifímicos de primera categoría y antimicóticos con buena respuesta clínica.

Relevancia clínica: La coinfección fúngica y tuberculosis pulmonar no es frecuente en pacientes inmunocompetentes, debe sospecharse en episodios abruptos de hemoptisis.

Keywords: Invasive candidiasis; coinfection; immunocompetent; pulmonary fungal infection; pulmonary tuberculosis.

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Conflict of interest statement

Conflict of interest: None to declare

Figures

Figure 1.
Figure 1.. Front to back and lateral chest x-rays. It was taken in the fifth day after the symptoms started, where it's identified a revetment in the soft parts of the normal thorax. The diaphragm is in the normal position and free Costophrenic angles. It is appreciated the increase in density of the interstitial left apical location with interstitial left apical in relation to the regarding consolidative process. The pulmonary vasculature or the aorta showed no alterations. The situation and the limits of the trachea are normal. No paratracheal lines widening and no displacement of the different mediastinal lines.
Figure 2.
Figure 2.. Torax CAT in hight resolution. The soft tissues and the osseous structures of the thoracic walls show no alterations. There is no evidence of pleural effusions nor intrapleural or extrapleural lesions. It is observed a thickening and an alveolar occupation with cavitation apical posterior left upper lobe area finding nodules with budding tree pattern in both lung apexes. The trachea, the Mainstem bronchi and lobar bronchi which are visualized are normal. There is no evidence of mediastinal masses. The cardiac silhouette, big blood vessels and other vascular structures visualized do no show pathologic change significance.
See this image and copyright information in PMC

Comment in

References

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