Frequency of chronic pulmonary aspergillosis in patients treated for pulmonary tuberculosis at a tertiary care hospital in Karachi, Pakistan

<b>Background:</b> Chronic pulmonary aspergillosis (CPA) is a progressive and destructive lung condition caused by members of aspergillus family and usually occurs in patients with lung conditions like COPD, lung cancer and tuberculous (TB). However, in high TB burden countries, TB remains one of the most common risk factor for CPA. <b>Objective:</b> To study the frequency of CPA in patients treated for pulmonary TB at a tertiary care hospital. <b>Methods:</b> Retrospective study done on patients treated for pulmonary TB and diagnosed as CPA on the basis of clinical symptoms, radiographic imaging and evidence of aspergillus infection on sputum culture or a positive <i>Aspergillus</i> specific IgG at Aga Khan University Hospital, Karachi, Pakistan from January 2016 to December 2018. <b>Results:</b> During the study period 115 patients were included in the study. The mean age was 56 (SD±13.4) years and 61 (53%) patients were females. Out of 115 patients, 17(14.78%) patients were diagnosed as CPA. Out of these 17 patients, 6 (35.29%) had pleural thickening, 5 (29.41%) had fibrocavitatory changes, 4 (23.52%) had consolidation and 2 (11.76%) had aspergilloma on radiological imaging. The growth of <i>Aspergillus</i> on sputum culture was seen in 9 (52.94%) patients while rest of the 8 (47.05%) patients had a positive <i>Aspergillus</i> specific IgG. Out of the 9 sputum culture positive patients, 7 patients had growth of <i>Aspergillus fumigatus</i> and rest of the 2 had growth of <i>Aspergillus flavus</i>. <b>Conclusion:</b> The prevalence of CPA in patients treated for pulmonary TB is underrated. After the cure of TB, if patient presents with chronic respiratory symptoms, CPA should be in the differential diagnosis.