عفونت قارچي در نمونه هاي شستشوي برنش در بخش برنكوسكپي بيمارستان امام رضا(ع) مشهد در سال 1383 و 1384

Fungal Infection in Samples of Bronchial washing in the Department of Bronchoscopy in Emam Reza Hospital of Mashhad in 2004-2005

Bronchoscopy can help us to take specimen from distal part of the lung in order to diagnose deep-seated fungal infections. Diagnosis of deep-seated fungal infections in lung parenchyma is relatively difficult. Therefore, it has been difficult to evaluate the prevalence and prognosis of pulmonary fungal infection. The obj ective ofthis study is to determine the utility ofbronchoscopy with bronchoalveolar lavage (BAL) for the diagnosis of fungal infections. This study was a prospective study of the patients submitted for routine bronchoscopy as both in- and out-patients in Emam Reza University Hospital. A total of 95 patients took part in the study.Using standard methods; the specimens were taken through Bronchoscopy with bronchoalveolar lavage. Then, the specimens were sent to the mycology laboratory in order to prepare direct smear and culture for the isolation of fungus. In the case of lavage, an aliquot was also studied for cellular morphology. The most frequently isolated fungi were Candida albicans which were estimated as 33.7% (32/95) followed by Aspergillus species at a rate of 8.4% (8/95). Malassezia species was isolated only from one patient. In 14.7% of samples direct smear was positive for fungus while in 43 cultured samples (45.3%), fungal colonies were observed. The Microscopic study of the stained smear revealed that 68% of patients had significant inflammatory cells in their BAL. Bronchoscopy with BAL is useful for diagnosing fungal infections. Candida albicans is one of the most common fungi that could be isolated from BAL.