Abstract
Background: Many of interstitial lung diasease are tend to impair the immunity, thus patients in this group have a higher risk of fungal diseases. But still little is known regarding the role of fungal colonization in interstitial lung diseases, when fungi are not definite a causative agent.
Aim: To investigate the incidence and effects of fungal colonization of lower respiratory tract using PCR of bronchaoalveolar lavage (BAL) specimens among patients with sarcoidosis and extrincsic allergic alveolitis (EAA).
Materials: 132 patients with sarcoidosis, and 80 patients with EAA undergo BAL with further PCR test for A. fumigatus and C. albicans using commercial assays. Cytology of BAL, different disease parameters including functional tests, radiology were analyzed.
Results: In sarcoidosis patients, Aspergillus was found in 22 cases (16.7%), 14 were males, and Candida detected in 11 cases (8.3%) - 3 were males. Among EAA patients, Aspergillus detected in 13 cases (16.2%), 5 were males, and Candida in 9 (11.3%) cases, 4 were males. In sarcoidosis, Candida colonization was associated with lower FVC (72%), DLCO (64%), and higher neutrophils level in BAL (32%), as also disease duration (112.8 weeks) vs patients without it (92%, 88%, 9% and 38.2 weeks, respectively). In EAA Candida detection was also associated with lower DLCO (58%), 6-minute walk test distance (340 m), higher neutrophils level in BAL (34%), disease duration (107.3 weeks) vs patients without it (72%, 421 m, 12% and 48.7 weeks, respectively). Aspergillus detection altered disease parameters in similar way.
Conclusion: Colonization of respiratory tract with fungi in interstitial lung diseases plays a prominent role in deterioration of disease.
- © 2011 ERS
