Allergic bronchopulmonary aspergillosis (ABPA) is an immunologically mediated lung disease caused by principally spores of Aspergillus fumigatus especially in asthmatic patients. Various set of diagnostic criteria has been advocated in different studies without a prevailing definition Treatment is based mainly on oral corticosteroids with the possible addition of antifungal agents.
We present a case of ABPA in an asthmatic patient who suffered of dyspnoea, coughing with green-brown sputum, pain in the left hemithorax, that has been admitted to our pulmonology department, with an initial suspicion of pulmonary neoplasm and pneumonia. CT scans showed consolidation at left ilo-apical site of the lung. Following blood tests and results of endoscopic examination that reports positivity for Aspergillus fumigatus, we make diagnosis of allergic aspergillosis and we start therapy with oral corticosteroid and antimycotic drug. At the follow up we found an exacerbation, but continuing therapy the symptomatology has improved.
ABPA is a well-established entity but the lack of uniform classification criteria creates further difficulties in the diagnosis. Analysis of anamnestic and radiological data with blood tests can help in the identification of this pathology that can mimicky other entities as in our case.