Case history
Case history #1
A 25-year-old man with asthma presents with complaints of cough, fever, and expectoration of brown mucus plugs for 3 months. Although he has known allergic rhinitis and asthma, he feels his symptoms were previously well controlled on his regimen of oral antihistamines and inhaled corticosteroids. His exam is significant for end-expiratory wheezing.
Case history #2
A 16-year-old girl with known cystic fibrosis presents to the accident and emergency department with an acute exacerbation of her chronic cough and wheezing. She has noticed an increase in sputum production and decreased exercise tolerance.
Other presentations
Uncommonly, allergic bronchopulmonary aspergillosis (ABPA) may present in patients with no prior history of asthma or cystic fibrosis. Such presentations have mostly been described in case reports or case series in the literature, including cases presenting as atelectasis due to mucus plugging that were initially investigated for bronchogenic carcinoma, and cases that presented with diffuse nodules initially concerning for possible pulmonary/miliary TB.[7]
In terms of associated diseases, ABPA is primarily seen in asthma and cystic fibrosis; however, it has also been described in non-CF bronchiectasis, COPD (especially with the recent recognition of an eosinophilic phenotype of COPD), and more rarely in hyper-IgE syndromes, chronic granulomatous disease, and lung transplant recipients.[8][9]
Use of this content is subject to our disclaimer