Abstract
IntroductionThe coexistence of allergic bronchopulmonary aspergillosis and aspergilloma is rare.Case presentationWe present the case of a 56-year-old Caucasian man who worked as a farmer, with infiltrates in the right lower and middle lung lobes, partial consolidation of the middle lobe and with previous diagnosis of chronic obstructive bronchitis. Evaluation of our patient led to the diagnosis of allergic bronchopulmonary aspergillosis with coexistent aspergilloma in the right lower lobe. He was treated with oral methylprednisolone and itraconazole. At the five-year follow-up he is without any sign of recurrence.ConclusionAspergillus infection after the inhalation of spores in the form of a hypersensitivity reaction and saprophytic colonization can be coexistent.
Highlights
The coexistence of allergic bronchopulmonary aspergillosis and aspergilloma is rare.Case presentation: We present the case of a 56-year-old Caucasian man who worked as a farmer, with infiltrates in the right lower and middle lung lobes, partial consolidation of the middle lobe and with previous diagnosis of chronic obstructive bronchitis
Allergic bronchopulmonary aspergillosis (ABPA) is a complex hypersensitivity reaction in patients with asthma, which occurs when bronchi are colonized by the fungus Aspergillus, most often Aspergillus fumigatus
Aspergilloma is a saprophytic growth of fungus, usually A. fumigatus, in the lumen of an existing cavity, which does not invade the tissue
Summary
Allergic bronchopulmonary aspergillosis (ABPA) is a complex hypersensitivity reaction in patients with asthma, which occurs when bronchi are colonized by the fungus Aspergillus, most often Aspergillus fumigatus. A patient with ABPA developed a cavitary pulmonary lesion with characteristic radiological appearances of aspergilloma. A chest radiograph showed an infiltrate with cavitation in the right lower lobe. Tuberculine testing was positive and our patient received tuberculostatic therapy without any improvement over the following four weeks. A chest radiograph showed the infiltrates with cavitation in the right lower lobe and in the middle lobe with consolidation of the latter (Figure 1). The chest radiograph disclosed that the infiltrate in the middle lobe resolved, but in the posterior segment of the right lower lobe a cavitary pulmonary lesion with the diameter of 3 cm and with an air crescent was formed. Chest CT showed tram-line shadows of bronchial wall thickening and cylindrical bronchiectasis in the middle lobe (Figure 4). He is being followed over a five-year period with no signs of recurrence
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