Co-infection of active pulmonary tuberculosis and invasive pulmonary aspergillosis following a liver transplant: a case report

We report a rare case of co-infection involving pulmonary tuberculosis and invasive aspergillosis following a liver transplant. A 25-year-old female housewife immigrant from Afghanistan, who had autoimmune hepatitis and underwent a liver transplant, presented with a history of fever and cough for over a month. Probable diagnosis of pulmonary tuberculosis and invasive aspergillosis was made by chest CT, as evidenced by a positive AFB and aspergillosis smear, and MTB PCR, along with the presence of galactomannan antigen in the BAL fluid. The patient improved after 9 months of treatment with anti-tuberculosis and anti-fungal. In an endemic setting, the probability of pulmonary tuberculosis is elevated, and co-infection with invasive pulmonary aspergillosis, though rare, is significantly more complex. Early detection and targeted management are crucial for improving outcomes.