To Determine the Previlance of Fungal Infection Among Patient with Sputum Negative Old Treated Pulmonary Tuberculosis

A descriptive study was conducted in the Department of Respiratory Medicine in a tertiary care center ofAmbala. Aim of the study was to determine the prevalence of fungal infection among patient presents withsputum negative old treated pulmonary tuberculosis. The study was carried out among 39 post treated casesof Pulmonary Tuberculosis, whose sputum or bronchial wash showed isolation of Aspergillus. Demographicdetails and clinical findings were noted. Data collected were entered into Excel spreadsheet and quantitativedata were expressed as number and percentage. The presentation of pulmonary aspergillosis in treated casesof pulmonary TB varies from aspergilloma (51.3%) to chronic necrotizing pulmonary aspergillosis (38.4%) toallergic bronchopulmonary aspergillosis (10.3%). Hemoptysis (79.5%) of varying severity was the mostcommon symptom. Most of the patients were farmers by occupation. The most common species wereAspergillus fumigatus; others were Aspergillus flavus, Aspergillus niger and Aspergillus terrus in 23.2%,20.5%, and 12.8 %, respectively. Here we conclude that Aspergillus fumigatus was the most frequentlyisolated species in our region and aspergilloma was the commonest pulmonary manifestation as post-TBsequel.

Fluorescent microscopy and Ziehl–Neelsen staining of bronchoalveolar lavage, bronchial washings, bronchoscopic brushing and post bronchoscopic sputum along with cytological examination in cases of suspected tuberculosis.

Objectives: Ever since the discovery of Mycobacterium tuberculosis in 1882, many diagnostic methods have been developed. However “The gold standard” for the diagnosis of tuberculosis (TB) is still the demonstration of acid fast Bacilli (AFB) by microscopic examination of smear or bacteriological confirmation by culture method. Materials and Methods: In suspected 75 patients with active pulmonary TB, the materials obtained bronchoscopically, were bronchoalveolar lavage (BAL), bronchial brushings, bronchial washings and post bronchoscopic sputum. Four smears were made from each of the specimen. Fluorescent Staining, Ziehl–Neelsen (ZN), Pap and May Grunwald‑Giemsa (MGG) stains were carried out for cytological examination. Results: Fluorescent stain yielded maximum AFB positivity in all the methods, that is 36 (48%) in post fibre‑optic bronchoscopy (FOB) sputum and 19 (25.33%) by fluorescence microscopy in both bronchial brushings and bronchial washings. Maximum yield of AFB with ZN staining 12 (16%) was equal to the post FOB sputum and bronchial brushings samples. It was followed by 6 cases (8%) in BAL and 4 (5.3%) in bronchial washings. The cytological examination was suggestive of TB in only 8 (10.66%) cases in bronchial washings and 6 (8%) cases in post FOB collection. It was equal in BAL and Bronchial brushings each that is 5 (6.67%). Conclusion: Bronchoscopy is a useful diagnostic tool and fluorescent microscopy is more sensitive than ZN and cytology. On X‑ray examination, other diseases like malignancy or fungus can also mimick TB. So apart from ZN staining or fluorescence microscopy, Pap and MGG stain will be worthwhile to identify other microorganisms.

Dengue shock syndrome in newborn: a case series.

Four cases of dengue shock syndrome were seen during an epidemic of dengue fever. Three cases recovered following appropriate management.