Discussion
TB, pulmonary disability, death, PTB, pulmonary cavitation, pulmonary fungal coinfection, pulmonary fungal infections, PTB or fungal infection
PULMONARY CAVITATION, DISEASE, BACTERIAL PNEUMONIA, HYPOPROTEINEMIA
People are susceptible to PTB or fungal infection when their immunity weakens. Both TB and pulmonary fungal infections increase the risk of co-infection with another disease, which may cause pulmonary disability and even death [Clinical characteristics of PTB patients with pulmonary fungal coinfection were associated with the illness course, pulmonary cavitation, use of broad-spectrum antibiotics for at least 1 week, chemotherapy or immunosuppressants, surgery, bacterial pneumonia, and hypoproteinemia, consistent with the findings of some previous studies [A nomogram was developed using the above predictors for facilitating individualized prediction of pulmonary fungal coinfection. For example, using the nomogram, we found that a PTB patient with pulmonary cavitation and an illness course of more than 1 year but no more than 5 years, had a 30% likelihood of pulmonary fungal coinfection. The nomogram can help clinicians improve decision-making for these patients.However, there are some limitations to our study. First, the training set was randomly selected from all PTB patients leading to lower evidence strength and failure in showing the incidence rate. Second, this was a single-center retrospective study, which inevitably suffered from confounding biases. Third, our predictive model is diagnostic but diagnosis requires some auxiliary examinations and is correspondingly time-consuming. The time for collecting outcome variables (maybe several days after hospital admission) sometimes may be several days compared to the predictors (hospital admission), contributing to a lower accuracy of the prediction model. Finally, only internal validation was performed to evaluate the discrimination ability and calibration of the scoring model, and external validation is warranted to confirm the performance of the nomogram (Additional file 