Allergic bronchopulmonary aspergillosis and the importance of diagnostic tests

Radiographic findings of allergic bronchopulmonary aspergillosis. Photo: Case Report.

This is a case of a previously healthy 22-year-old male who was not diagnosed or treated for Allergic Bronchopulmonary Aspergillosis due to a lack of asthma in the history, where delays in diagnosis and initiation of treatment have detrimental health consequences. such as irreversible structural lung injury and permanent loss of lung function, as seen in this case.

This reflects the need for more sensitive diagnostic tests to prevent progression to irreversible lung injury. Here we report on a 22-year-old Puerto Rican man who was not diagnosed with Allergic Bronchopulmonary Aspergillosis for 12 months due to the absence of history of asthma or Cystic Fibrosis.

The symptoms occurred acutely, with no identifiable precipitating factors. The medical history prior to the development of his symptoms was not remarkable. Family history was negative for lung disease or similar symptoms at home. During this time period, she required seven hospitalizations for suspected recurrent mycoplasma pneumonia.

During physical examination, the patient noted bilateral polyphonic wheezing in the lung fields. A spirometry showed severe obstruction of the respiratory tract, is highlighted in the case.

During the care process, treatment was started with oral prednisone 30 mg (0.5 mg/kg) daily for two weeks with the aim of alternating days of treatment for two months followed by prednisone 5 mg daily decreasing every two weeks, as well as corticosteroids. inhaled and albuterol rescue for relief symptomatic.

The relevance of the case concludes that the good prognosis of adequately treated Allergic Bronchopulmonary Aspergillosis indicates that it is recommended that doctors have a high suspicion disease when a patient presents with difficult-to-treat asthma, drug-resistant pneumonia, or tuberculosis, regardless of age or past medical history.

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Allergic Bronchopulmonary Aspergillosis

Allergic bronchopulmonary aspergillosis (ABPA) is a localized inflammatory disease of the airways seen in patients sensitized to Aspergillus fumigatus (A. fumigatus) antigens. The disease presents with productive cough, wheezing, episodic fever, as well as central bronchiectasis (CB) and mucus plugging on computed tomography (CT) scans. If treated properly, the symptoms and lung damage caused by ABPA can be reversed.

Currently, the diagnostic criteria for ABPA require the diagnosis of predisposing lung diseases such as asthma and cystic fibrosis (CF) in order to establish the diagnosis. There has been an increasing number of cases reporting ABPA without evidence of an asthmatic history or symptoms.

Access the case here.

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