Post-Tuberculosis Pulmonary Bronchiectasis with Fungal Lung Infection

Abstract

Background: Bronchiectasis is a permanent dilation of the bronchial tubes caused by chronic inflammation and recurrent respiratory tract infections. One of the main causes of bronchiectasis is pulmonary tuberculosis, which can lead to structural sequelae, while fungal lung infections also play a role in the pathogenesis and exacerbation of bronchiectasis. Fungi such as Candida albicans and Aspergillus spp., Which have high pathogenic potential, are often found in bronchiectasis patients due to impaired mucociliary clearance and the fungi's ability to evade host immune defenses. This case report discusses the pathophysiology, diagnosis, and management of post-tuberculosis bronchiectasis with fungal lung infection.

Case illustration: A 51 year-old male presented with shortness of breath and intermittent cough that worsened over the last three days, accompanied by weight loss and decreased appetite. His medical history revealed biologically confirmed pulmonary tuberculosis in 2024 with a six-month course of anti-tuberculosis treatment. Examination at Abdoel Moeloek Hospital showed post-TB bronchiectasis with fungal lung infection.

Discussion: Post-TB structural lung damage leads to mucociliary dysfunction that favors colonization by opportunistic fungi. Sputum culture revealed infection with Candida glabrata and Acinetobacter baumannii. Combination therapy with antibiotics, antifungals, and anti-inflammatory agents produced good clinical improvement. This case emphasizes the importance of early identification of fungal infection in post TB bronchiectasis to prevent disease progression.

Conclusion: Post-tuberculosis bronchiectasis incerases the risk of fungal lung infection. Early diagnosis and appropriate therapy can improve clinical outcommes and prevent further  complications.