Concomitant Pulmonary Tuberculosis and Invasive Aspergillosis Infection in an Immunocompetent Host

Pulmonary tuberculosis (TB) is a common infection in developing countries and is associated with low socioeconomic status. It is considered a serious infection due it its long-term sequelae. Post-TB lung disease decreases life expectancy and increases the risk of recurrent TB infection. It also significantly increases the risk of other bacterial and fungal infections. Aspergillosis develops in the cavitary lesions of TB, worsening them and resulting in a deteriorating clinical situation. Concomitant pulmonary TB (PTB) and invasive aspergillosis is uncommon, particularly in the absence of factors that suppress the immune system. In this report, we describe the case of a healthy young adult without previous structural lung damage who presented with primary PTB and acute invasive aspergillosis infection, discuss the treatment dilemma and provide a literature review. LEARNING POINTS: Aspergillosis can mimic tuberculosis (TB) infection. Concomitant pulmonary TB and invasive aspergillosis is uncommon. The co-administration of antifungal and anti-TB medications presents significant therapeutic challenges.