Publication:

Correlation of bronchoalveolar lavage fungal culture with clinical spectrum and radiological features: a retrospective study

Background Pulmonary fungal infections are an increasingly recognized cause of respiratory morbidity, particularly in immunocompromised individuals and patients with structural lung disease. Clinical and radiological features often overlap with tuberculosis and bacterial pneumonia, making diagnosis challenging. Bronchoalveolar lavage (BAL) based fungal culture and galactomannan assay are important diagnostic tools; however, their clinical relevance requires correlation with presentation and imaging findings.

Methods This retrospective observational study was conducted in the department of respiratory medicine at tertiary care hospital from June 2025- November 2025. Patient (>18 years) with BAL positivity for fungal culture, galactomannan assay (GM) was included. Clinical characteristics, comorbidities, immunological status and radiological findings on chest radiograph and computed tomography were analyzed. Statistical analysis was performed using IBM SPSS version 25.0. Continuous variables were expressed as mean and categorial variables as percentages. Fischer’s exact test was used with p<0.05 considered statistically significant.

Results 78 patients were included mean age 52.7 years. BAL fungal culture was positive in 48 patients, GM assay in 30, and both in 25 patients. Aspergillus species were the most common isolates (53.7%). Diabetes mellitus showed a significant association with fungal culture positivity(p=0.035). Consolidation was the most frequent radiological finding across all groups, while cavitary lesions were more common in patients positive for both GM and culture.

Conclusions Aspergillus species predominate in pulmonary fungal infections and are commonly associated with diabetes, post- tubercular lung disease and characteristic radiological patterns. Integrated clinical, radiological and microbiological evaluation is essential for early diagnosis and appropriate management in tuberculosis-endemic region.