Volume 26, Issue 120, February 2022

Allergic Bronchopulmonary Aspergillosis (ABPA) in pre existing chronic obstructive pulmonary disease (COPD)-A case report

Sagar VVSS^1♦, Sourya Acharya², Amol Andhale³, Samarth Shukla⁴, Sunil Kumar⁵, Chitturi Venkata Sai Akhil⁶

¹Resident, Department of General Medicine, Jawaharlal Nehru Medical College & Acharya Vinoba Bhave Rural Hospital, Sawangi (Meghe), Wardha, Maharashtra, India
²Professor and Head, Department of General Medicine, Jawaharlal Nehru Medical College & Acharya Vinoba Bhave Rural Hospital, Sawangi (Meghe), Wardha, Maharashtra, India
³Senior Resident, Department of General Medicine, Jawaharlal Nehru Medical College & Acharya Vinobha Bhave Rural Hospital, Sawangi (Meghe), Wardha, Maharashtra, India
⁴Professor, Department of Pathology, Jawaharlal Nehru Medical College & Acharya Vinoba Bhave Rural Hospital, Sawangi (Meghe), Wardha, Maharashtra, India
⁵Professor, Department of General Medicine, Jawaharlal Nehru Medical College & Acharya Vinoba Bhave Rural Hospital, Sawangi (Meghe), Wardha, Maharashtra, India
⁶Resident, Department of Pediatrics, Jawaharlal Nehru Medical College & Acharya VinobaBhave Rural Hospital, Sawangi (Meghe), Wardha, Maharashtra, India

^♦Corresponding author
Resident, Department of General Medicine, Jawaharlal Nehru Medical College & Acharya Vinoba Bhave Rural Hospital, Sawangi (Meghe), Wardha, Maharashtra, India;

ABSTRACT

Allergic bronchopulmonary aspergillosis (ABPA) is an entity of immunological pulmonary disease characterised by airway hyper-responsiveness to Aspergillus fumigatus colonised in the airways, as well as distinct radiological and serological findings. The case reported here is a 53-year-old farmer who was diagnosed with COPD seven years back presented with cough with expectoration, shortness of breath, wheeze. The radiological investigation revealed fleeting shadows, and a CT scan revealed central cystic bronchiectatic features, which are typical with ABPA. On further investigation the sputum examination revealed Aspergillus. Eosinophilia was found in peripheral blood smears, as well as elevated total IgE and fungus specific IgE levels in serum. As a result, ABPA was determined to be the cause. Management with steroids, antifungals improved patient symptoms and partial improvement in pulmonary infiltrates.

Keywords: Aspergillosis, asthma, COPD, eosinophilia, bronchiectasis, eosinophilia

Medical Science, 2022, 26, ms71e2072

PDF

DOI: https://doi.org/10.54905/disssi/v26i120/ms71e2072

Published: 19 February 2022