Respir Case Rep. 2018; 7(3): 134-139 | DOI: 10.5505/respircase.2018.20082

Changing Pulmonary Infiltrates in ABPA Misdiagnosed as Recurrent Pneumonia: A Case Report and Review of the Literature

Shital PATIL, Gajanan Gondhali
MIMSR MEDICAL COLLEGE LATUR INDIA

Pneumonia is the most common respiratory problem in tropical countries like India. Allergic bronchopulmonary aspergillosis (ABPA) is routinely underdiagnosed and under evaluated as a result of clinical and radiological overlap with many other respiratory conditions, including pneumonia and tuberculosis. ABPA is the best-recognized manifestation of the fungus Aspergillus, associated with hypersensitivity to Aspergillus antigens in patients with longstanding atopic asthma. ABPA has been reported to occur in 20% of asthmatic patients admitted to hospitals and in 5% of all rhinitis cases, with varied clinical presentations. This report is a description of the case of a middle-aged male with known asthma for several years and constitutional symptoms, such as a cough, fever, and shortness of breath, who was diagnosed and treated for recurrent pneumonia. The case was eventually confirmed as ABPA, and a complete clinical and radiological response to medical treatment with antifungals and systemic corticosteroids was documented.

Keywords: ABPA, Recurrent pneumonia, fleeting pulmonary infiltrates

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Tekrarlayan Pnömoni Olarak Yanlýþ Taný Konan ABPA Olgusunda Deðiþen Pulmoner Ýnfiltratlar: Olgu Sunumu ve Literatürün Gözden Geçirilmesi

Shital PATIL¹, Gajanan Gondhali¹

Pnömoni, Hindistan gibi tropikal ülkelerde en sýk görülen solunumsal problemdir. Allerjik bronkopulmoner aspergillozis (ABPA), pnömoni ve tüberküloz gibi solunumsal hastalýklar ile klinik ve radyolojik olarak karýþtýrýldýðý için genellikle tanýda ve incelemelerde atlanmaktadýr. ABPA, uzun süreli atopik astmalý hastalarda Aspergillus antijenine aþýrý duyarlýlýk ile karakterize, aspergillus mantarýna ait en iyi tanýmlanmýþ bir tablodur. ABPA’nýn hastaneye yatýrýlan astmatik hastalarýn %20’sinde ve tüm rinit olgularýnýn %5’inde çeþitli klinik tablolarla ortaya çýktýðý bildirilmiþtir. Burada, öksürük, ateþ, nefes darlýðý gibi yakýnmalarý ile tekrarlayan pnömoni tanýsý ile tedavi edilen, birkaç yýldýr astým olduðu bilinen orta yaþlý erkek olgu sunulmuþtur. Bu olguda, sonuçta ABPA olarak taný konmuþ ve sistemik steroid ve antifungal tedavi ile tam klinik ve radyolojik iyileþme saðlanmýþtýr.

Anahtar Kelimeler: ABPA, tekrarlayan pnömoni, pulmoner infiltrat

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