Allergic Bronchopulmonary Aspergillosis Coupled with Sinusitis in a Nonasthmatic Patient.

Park, Sung Woon; Choi, Jae Chol; Kim, Jae Yeol; Park, In Won; Choi, Byoung Whui; Shin, Jong Wook

doi:2011.71.4.278

Tuberc Respir Dis > Volume 71(4); 2011 > Article

Case Report

Tuberculosis and Respiratory Diseases 2011;71(4):278-281.
DOI: https://doi.org/10.4046/trd.2011.71.4.278 Published online October 1, 2011.

Allergic Bronchopulmonary Aspergillosis Coupled with Sinusitis in a Nonasthmatic Patient.

Sung Woon Park, Jae Chol Choi, Jae Yeol Kim, In Won Park, Byoung Whui Choi, Jong Wook Shin

Division of Allergy, Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea. basthma@cau.ac.kr

Abstract

Allergic bronchopulmonary aspergillosis (ABPA) is a complex clinical entity resulting from an allergic immune response to Aspergillus species, and most often occurs in patients with asthma. ABPA is rarely observed in the absence of asthma, which is, in fact, the principal criterion for its diagnosis. Our patient was a 53-year-old woman with no history of bronchial asthma. She presented with a 1-month history of cough, mucopurulent nasal discharge, and localized pulmonary consolidation. Peripheral blood eosinophilia and elevated serum IgE were observed. Sinus radiography showed right maxillary sinusitis. Pathologic examination of bronchoscopic biopsy specimens revealed conglomerates of fungal hyphae. Pulmonary function and bronchial provocation tests were within normal ranges. The patient was successfully treated for 3 months with itraconazole and oral prednisolone. There has been no evidence of recurrence over a 7-month follow-up. ABPA coupled with sinusitis in a nonasthmatic patient is a very rare occurrence and warrants reporting.

Key Words: Aspergillosis, Allergic Bronchopulmonary, Sinusitis, Asthma