02604nas a2200181 4500000000100000008004100001260001000042100001300052700001100065700001300076700001200089245006600101856005100167300001200218490000700230520217100237022001402408 2020 d bLepra 1 aSamaan M 1 aMusa H 1 aHassan Y 1 aSaeed M 00 aFungal carriage and infection among leprosy patients in Sudan uhttps://leprosyreview.org/article/91/2/19-0034 a139-144 0 v91 3 aLeprosy 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. a2162-8807