The Coexistence of Pathogenic Fungi in Certain Chronic Pulmonary Diseases: With Especial Reference to Pulmonary Tuberculosis

A Preliminary Report

¹ Houston, Texas

An investigation was instituted to determine the incidence of fungi in the oral sputum of 301 patients residing principally in the Houston Tuberculosis Hospital. In 45 (15 per cent) of these 301 patients, fungi were primarily isolated from the oral sputum by direct smear and by culture in Sabauraud's dextrose medium; in 18 cases (6 per cent), fungi individually identical with the ones found in the sputum were isolated by carefully controlled washing of the trachea. These latter 18 patients were selected for an intensive study, which will be reported subsequently in greater and more minute detail, as this paper is intended only for a general survey of the salient features of our work.

We believe, however, we are justified in the following conclusions:

1) Parasitic fungi may be found in the tracheal sputum of at least 4 per cent of tuberculous patients;

2) The finding of fungi in the mouth sputum alone does not assure their presence, also, in the trachea; and, therefore, by inference, in the bronchi and lungs;

3) In 60 per cent of patients the finding of fungi in sputum from the mouth alone may indicate only the presence of saprophytic, harmless contaminants;

4) Fungi obtained from the trachea and cultured on Sabauraud's dextrose medium will produce, when injected into the lungs of rabbits, localized and generalized lesions in their lungs, from which the same fungi may be obtained;

5) There seems to be a tendency for the pulmonary tuberculosis to develop a more devastating course when it is associated with an invasion of parasitic fungi;

6) The coexistence of fungous and tuberculous infections should be more frequently considered in the diagnosis of chronic pulmonary diseases.