Post-tuberculosis chronic pulmonary aspergillosis: An emerging public health concern

About the Authors: Felix Bongomin * E-mail: drbongomin@gmail.com Affiliation: Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda ORCID logo http://orcid.org/0000-0003-4515-8517 Introduction Tuberculosis (TB) caused by Mycobacterium tuberculosis complex is the leading cause of death and diseases from a single infectious agent and continues to be a major global public health problem [1]. The diagnosis of CPA requires a combination of characteristics: one or more cavities with or without a fungal ball present or nodules on thoracic imaging, direct evidence of Aspergillus infection (microscopy or culture from biopsy) or an immunological response to Aspergillus spp., and exclusion of alternative diagnoses, all present for at least 3 months [22,26]. Concurrent treatment of CPA and TB is very challenging due to the significant drug-drug interactions between anti-TB agents and the triazoles. Long-term oral antifungals with itraconazole at a dose of 400 mg/day or voriconazole at a dose of 400 mg/day administered for at least 6 months is the recommended first-line therapy for CPA associated with improvement in quality of life, relief of symptoms, and retardation of disease progression [38,39].