To analyze the clinical characteristics, clinical diagnosis and treatment of pulmonary tuberculosis complicated with pulmonary aspergillus infection.

The clinical data of 76 patients with pulmonary tuberculosis complicated with pulmonary aspergillus infection in our hospital from January 2019 to December 2019 were retrospectively analyzed. The clinical characteristics, diagnosis and treatment of pulmonary tuberculosis complicated with pulmonary aspergillus infection were analyzed.

Among 76 patients with tuberculosis complicated with pulmonary aspergillus infection, the proportion of chronic obstructive pulmonary disease was 30.26% (23/76), the proportion of diabetes was 23.68% (18/76), the proportion of bronchiectasis was 15.79% (12/76), the proportion of bronchial asthma was 11.84% (9/76), the proportion of agranulocytosis was 10.53% (8/76), the proportion of pneumoconiosis was 7.89% (6/76). In the clinical manifestations of patients with pulmonary tuberculosis complicated with pulmonary aspergillus infection, the proportion of fever was 35.53% (27/76), the proportion of cough and expectoration was 100.00% (76/76), the proportion of hemoptysis was 69.74% (53/76), the proportion of chest pain was 14.47% (11/76), the proportion of dyspnea was 5.26% (4/76), and the proportion of asymptomatic manifestations was 6.58% (5/76). The CT images of pulmonary tuberculosis complicated with pulmonary aspergillus infection showed nodules, consolidation, voids, and crescent signs. Among them, consolidation usually occurred in one side and upper lung, nodules were more common in one side, and voids and crescent signs were more common in upper lung. The detection rate of CT on pulmonary tuberculosis complicated with pulmonary aspergillus infection was 86.84% (66/76), the detection rate of sputum culture was 75.00% (57/76), and the detection rate of pathological examination was 100.00% (76/76). All 76 patients were given anti-TB treatment, of whom 12 patients underwent surgical resection of lesions, 17 patients underwent bronchoscopy interventional therapy and were all given antimicrobial therapy after surgery, 34 patients underwent bronchoscopy antimicrobial therapy, and 13 patients were given antimicrobial therapy. All patients were revisited after 3 months of treatment. During the follow-up, only 2 patients who were treated with antimicrobial drugs only had aggravated conditions, others did not have recurrence of aspergillus infection or exacerbation.

There are many susceptible factors for pulmonary tuberculosis complicated with pulmonary aspergillus infection. The clinical manifestations are mostly presented by hemoptysis, cough and expectoration, and other symptoms. The imaging features and clinical manifestations are not typical, pathological examination is the gold standard in the diagnosis of this disease. Clinical treatment of this disease should be based on the patients' own needs and condition to formulate a reasonable treatment plan.

Pulmonary tuberculosis; Pulmonary aspergillus infection; Clinical features; Imaging features