| Objective To study the clinical features and the correlated factors of pulmonary tuberculosis complicated by fungi infection. To improve the understanding of the two disease coexist and to provide the reference for the early stages diagnosis of the disease. The Aims is to deepen our understanding of the disease in such patients, it will play an important role in early diagnosis and treatment, improving the curative effect and controlling of infectious diseases.Methods Retrospective analysis of the 381 cases who diagnosed pulmonary tuberculosis from July 2003 to July 2010 at the Second Affiliated Hospital of Chongqing Medical University,among them the number of pulmonary tuberculosis complicated by fungal infection is 102 cases and 279 cases tuberculosis patients without pulmonary fungus infection。Results①The major type of fungi infected in the patients with pulmonary tuberculosis were Candida albicans whether infected mixed type of fungi(66.7%).②The elderly and course long patients are more vulnerable to fungal infection:in the case group the rate of age > 60 years old is 59.3%,the rate of course> 10 years is 58.9%.③The result of case—control study showed that the influencing factors on pulmonary tuberculosis complicated by fungal infection were correlated with a medical history of tuberculosis,the secondary tuberculosis, There were significant differences in these factors between observation group and control group (P<0.05 ).④Long-term use broad-spectrum antibiotics and powerful glucocorticoid increased the risk of tuberculosis merger fungal infections: During anti-tuberculosis drug treatment ,all of the case group patients use antibiotics. Among them, the ratio of prolonged or repeated use broad-spectrum antibiotics patients is 56.5%.And in order to control the temperature and reducing tuberculosis poisoning symptoms, the 51.9% patients simultaneous use glucocorticiod, all of the application time is longer than 10 days. .⑤pulmonary tuberculosis complicated by fungi infection is more common in secondary tuberculosis.⑥pulmonary tuberculosis complicated by fungi infection compared with pure tuberculosis patients ,the incidence of hemoptysis ,expectoration, dyspnea, Lung moist rales are all increased and the statistically difference is significant (P < 0.05)⑦positive rate of sputum acid fast stain is decreased in pulmonary tuberculosis complicated by fungi infection patients(33.2%),while hypoalbuminemia incidence(40.2%) increased significantly.⑧pulmonary tuberculosis complicated by fungi infection compared with pure tuberculosis patients , as for the imaging ,except withwider lesions range(≥3 lung field 46.1%), more common cavity (52%),the rest have no obvious difference.Conclusions The number of patients with pulmonary tuberculosiscomplicated by fungi infection is increasing .And older, the long course,lesions range, retreatment secondary tuberculosis, corticosteroids andlong-term use of antibiotics, All the above factors increase its incidencesignificantly. The clinical characteristics of pulmonary tuberculosiscomplicated by fungi infection compared with pure tuberculosis patient hasno obvious specificity ,then leading to pulmonary fungus infection waseasy to misdiagnosis and missed diagnosis .But,if patient's condition hasnot obvious improvement after antitubercular treatment,or after diseasestates improving, the repeated hyperpyrexia , jelly-like sputum,hemoptysis(including blood steak in sputum) which indicates poor hematischesiseffect, and the increasing range of focus through iconography method withrelatively specifically manifestation such as globe shaped change incavity ,meniscus sign and halo sign should demonstrates potential mycoticinfection. Therefore, combined with influence factors, clinical signs andsymptoms, radiculopathy these three aspects,as early as possible to takefungal infection related tests. Try to be early detection, early diagnosis andearly treatment, the aim is to reduce the incidence of misdiagnosed,improve patient's prognosis.
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