Coexistence of Pulmonary Aspergilloma and Allergic Bronchopulmonary Aspergillosis
نویسندگان
چکیده
A 63-year-old man with a history of pulmonary Mycobacterium tuberculosis and asthma was admitted to our hospital due to wheezing and coughing in the early morning. Chest radiography and computed tomography revealed a fungal ball in a thick-walled cavity in the right upper lobe, and consolidation with high-attenuation mucus in the left lower lobe (Picture 1, 2). In addition to Aspergillus fumigatus cultured from the bronchial washing specimens and the mucus plug, Charcot-Leyden crystals and fibrinpurulent material with eosinophil infiltration were found. Specific IgE and IgG antibodies against Aspergillus fumigatus were positive. These findings were consistent with a diagnosis of coexistence of allergic bronchopulmonary aspergillosis (ABPA) and pulmonary aspergilloma. Cases of ABPA concomitant with pulmonary aspergilloma have been previously reported (1, 2). Corticosteroids for ABPA increase the risk of pulmonary aspergilloma development, and pulmonary aspergilloma likewise increases the severity of ABPA. Therefore, both corticosteroids and antifungal medication are needed in such cases.
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