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Fungal carriage and infection among leprosy patients in Sudan
Abstract
Leprosy patients often develp wound infections. While clinicians routinely focus on bacterial causes they usually forget the possibility of the presence of co-infection with opportunistic fungi that may cause complications or a delay in the healing process.
Objective:
This study looked for fungal carriage and co-infection among lepromatous leprosy patients with ulcers in Sudan.
Methods:
Swabs from infected ulcers, plus swabs from the ear, nose and eye of a sample of lepromatous leprosy patients were collected to look for fungal elements; similar swabs were collected from the ear, nose and eye of leprosy-free, healthy controls. The swabs were examined microscopically using 20% KOH and cultured on Sabouraud’s agar. Fungal growth was identified by colony morphology, gram stain, biochemical tests, Chlamydospore formation, API 20 C Aux and needle mount technique.
Results:
30 patients with leprosy and 30 healthy controls were recruited. In total fourteen fungal elements were isolated from the infected ulcers, of which seven were C. albicans (23%), four A. fumigatus (13%), two A. Niger (7%) and one A. flavus (3%). The total number of different fungal elements recovered from the ear, nose and eyes of leprosy patients was 41 (45.6%) from 90 specimens, the highest number of fungi being isolated from the ear (16/41). The total number of fungal species isolated from leprosy-free healthy controls was 12/90 (13.3%) and the commonest isolate was A.niger (7/12). The difference in fungal carriage between the leprosy patients and healthy controls is significant. A. flavus was the commonest isolate among all fungal carriage from the eye; 8 (26.7%), nose, 6 (20%) and ear 4 (13.3%), while A.niger was the second commonest 5 (16.7%) from the ear.
Conclusions:
The frequency of fungal isolates from infected wound ulcers and carriage sites was high amongst leprosy patients, as compared to the leprosy-free group. It is recommended that clinicians should consider fungi as a possible cause of infection, especially for corneal ulcers, and to consider antifungal drugs to manage such conditions.
Objective:
This study looked for fungal carriage and co-infection among lepromatous leprosy patients with ulcers in Sudan.
Methods:
Swabs from infected ulcers, plus swabs from the ear, nose and eye of a sample of lepromatous leprosy patients were collected to look for fungal elements; similar swabs were collected from the ear, nose and eye of leprosy-free, healthy controls. The swabs were examined microscopically using 20% KOH and cultured on Sabouraud’s agar. Fungal growth was identified by colony morphology, gram stain, biochemical tests, Chlamydospore formation, API 20 C Aux and needle mount technique.
Results:
30 patients with leprosy and 30 healthy controls were recruited. In total fourteen fungal elements were isolated from the infected ulcers, of which seven were C. albicans (23%), four A. fumigatus (13%), two A. Niger (7%) and one A. flavus (3%). The total number of different fungal elements recovered from the ear, nose and eyes of leprosy patients was 41 (45.6%) from 90 specimens, the highest number of fungi being isolated from the ear (16/41). The total number of fungal species isolated from leprosy-free healthy controls was 12/90 (13.3%) and the commonest isolate was A.niger (7/12). The difference in fungal carriage between the leprosy patients and healthy controls is significant. A. flavus was the commonest isolate among all fungal carriage from the eye; 8 (26.7%), nose, 6 (20%) and ear 4 (13.3%), while A.niger was the second commonest 5 (16.7%) from the ear.
Conclusions:
The frequency of fungal isolates from infected wound ulcers and carriage sites was high amongst leprosy patients, as compared to the leprosy-free group. It is recommended that clinicians should consider fungi as a possible cause of infection, especially for corneal ulcers, and to consider antifungal drugs to manage such conditions.
More information
Type
Journal Article