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Faisal, Hana Khairina Putri
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Health Professions Medicine & Pharmacology Public Health

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Fungal Profile in Patients with Lung Cancer Receiving First-Line Chemotherapy Faisal, Hana Khairina Putri; Aziziah, Aziziah; Pane, Irene Audrey Davalynn; Hasyim, Ammar Abdurrahman; Zaini, Jamal; Rozaliyani, Anna
Jurnal Respirasi Vol. 11 No. 3 (2025): September 2025
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v11-I.3.2025.250-255

Abstract

Introduction: Patients with lung cancer are vulnerable to opportunistic infections, particularly fungal pulmonary infections such as those caused by Aspergillus spp., due to immunosuppression from both the disease and chemotherapy. Despite the clinical significance of these infections, data on their prevalence and associated factors in patients with lung cancer remain limited. This study aimed to determine the prevalence of Aspergillus spp. and identify associated factors in patients with lung cancer who underwent first-line chemotherapy at a national respiratory referral hospital in Indonesia. Methods: A cross-sectional study was conducted among 50 patients with lung cancer who had completed at least three cycles of chemotherapy. Sputum cultures were performed using Sabouraud dextrose agar (SDA), and serum immunoglobulin G (IgG) antibodies were tested using immunochromatographic assays. Demographic, clinical, and radiological data were collected. Bivariate and multivariate logistic regression analyses were used to identify factors associated with Aspergillus spp. infection. Results: Aspergillus spp. was detected in 92.0% of patients via sputum culture, with A. niger and A. fumigatus as the most common isolates. Over 30% showed co-colonization with other fungal species, such as Candida. Multivariate analysis revealed that a high Brinkman Index was independently associated with Aspergillus spp. colonization (p<0.05). Serum IgG antibody positivity was low (4%). Conclusion: There was a high prevalence of Aspergillus spp. colonization among patients with lung cancer undergoing chemotherapy, with smoking history emerging as a key risk factor. Targeted fungal screening is recommended, especially in heavy smokers, to facilitate early detection and improve outcomes.
Pulmonary Aspergilloma Co-Existing with Pulmonary Tuberculosis: A Case Report in Type 1 Diabetes Mellitus (T1DM) Patient Kirana, Widya Tria; Faisal, Hana Khairina Putri; Kitagawa, Hiroki; Setiawan, Gigih; Yunus, Faisal
Jurnal Respirasi Vol. 9 No. 3 (2023): September 2023
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v9-I.3.2023.213-219

Abstract

Introduction: Pulmonary aspergilloma is a disease frequently found in immunocompromised patients. In Indonesia, around 18% of diabetes mellitus (DM) patients suffer from chronic pulmonary aspergilloma. However, data on type 1 DM (T1DM) are still limited. Case: We presented the case of a 22-year-old male admitted to the emergency room due to hemoptysis of approximately 200 ml within six hours before admission, nonspecific chest pain during cough, fever, night sweats, and weight loss of 3 kg over the last months. The patient had a history of T1DM and no prior history of respiratory diseases. Physical examination showed tachycardia, tachypnoea, subfebrile, normal body mass index, and rhonchi on the left thorax. Routine laboratory tests revealed increased blood sugar level (503 mg/dL) and HbA1c 16.4%. Chest X-ray and high-resolution computed tomography (HRCT) showed a cavity with an opaque lesion, crescent sign, consolidation, and reticulonodular infiltrate on the left lung. Rapid molecular tests, tuberculosis (TB), and serum galactomannan (GM) were negative. The patient was diagnosed with pulmonary aspergilloma, T1DM, and clinical TB. He was treated with fluconazole, insulin, and a fixed-dose combination of anti-TB. The patient refused the surgery procedure. Immediately, the hemoptysis stopped, blood glucose level was normal, and concomitant with weight gain. Conclusion: Due to innate and acquired immunity impairment, T1DM is a risk factor for pulmonary infections, including TB and pulmonary aspergilloma. Chest HRCT may help diagnose fungal balls. Though the patient refused to undergo surgery, administering antifungal, anti-TB drugs, and glucose control as initial treatment presented a good prognosis in the patient.
Co-Authors Anna Rozaliyani Aziziah, Aziziah Faisal Yunus Hasyim, Ammar Abdurrahman Kirana, Widya Tria Kitagawa, Hiroki Pane, Irene Audrey Davalynn Setiawan, Gigih Zaini, Jamal