Allergic bronchopulmonary aspergillosis masquerading as pulmonary tuberculosis

We present an unusual pediatric patient with severe allergic bronchopulmonary aspergillosis that masqueraded as pulmonary tuberculosis. After antituberculous therapy, the patient's pulmonary disease flared, prompting an aggressive diagnostic evaluation. Radiographic findings included nodular pulmonary densities with superimposed infiltrates. Lung biopsy showed evidence of acute and chronic inflammation with necrotizing granulomas, giant cells, tissue eosinophilia and rare hyphal elements.