Background: The coexistance among fungal pathogens and tuberculosis pulmonary is a clinical condition that generally occurs in immunosuppressive patients, however, immunocompetent patients may have this condition less frequently. Objective: We report the case of an immunocompetent patient diagnosed with coinfection Mycobacterium tuberculosis and Candida albicans. Case Description: 22-year-old female patient, previously healthy, who presented an episode of cough, massive hemoptysis and fever. Clinical findings and diagnosis: Physical examination was found crakles in left lung. Microbiological testing includes Ziehl Neelsen, culture for mycobacterium, fungal culture in Sabouraud Dextrose Agar medium and serum filamentation. The tests showed Mycobacterium tuberculosis and Candida albicans. Imaging studies included chest radiography, chest CT scan apicograma and high resolution supported the diagnosis. Treatment and Outcome: The patient was treated with anti-tuberculosis and anti-fungal treatment with good clinical evolution. Clinical relevance: Fungal infection and pulmonary tuberculosis is rare in immunocompetent patients should be suspected in abrupt episodes of hemoptysis.
In response to the note about the case described 1, we fully agree that immunodeficiency is not only the relationship with HIV infection, and that there are pathologies and different immunological and genetic conditions associated with it 2-4; the main ones were discarded in the patient. In the patient of the presented clinical case, there is no family history of primary immunodeficiencies. And in her personal history, there were not found any data related to recurrent infectious processes, either in childhood or present, which does not lead to suspicion of diseases with primary immunodeficiencies, in which recurrent infections would be expected as in the case of recurrent pneumonia, lung, spleen and liver abscesses, cervical, axillary and inguinal lymphadenitis, or bone and skin infections, as in the case of chronic granulomatous disease 5. For other primary immunodeficiencies provided by the reader, such as the case of X-linked agammaglobulinemia, this is a congenital disease that affects males and involves B lymphocytes and plasma cells, which are not the primary immune line in tuberculosis6, nor does it correspond to our case.
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