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Published on: March 9, 2018
A rare cause of acute respiratory failure--allergic bronchopulmonary aspergillosis
Abstract:
Allergic bronchopulmonary aspergillosis (ABPA) is a complex immune hypersensitivity reaction to Aspergillus fumigatus, usually complicating the course of patients with asthma and cystic fibrosis. The common radiological manifestations encountered are fleeting pulmonary opacities, bronchiectasis and mucoid impaction. Uncommon radiological findings encountered in ABPA include pulmonary masses, perihilar opacities simulating hilar adenopathy, miliary nodules and pleural effusions. Herein, we describe a 22-year-old female patient who presented with acute hypoxaemic respiratory failure secondary to left lung collapse, which necessitated rigid bronchoscopy for management. On further evaluation, she was diagnosed to have ABPA. This is the first documented report of ABPA presenting as acute hypoxaemic respiratory failure secondary to lung collapse.
Insights
Allergic bronchopulmonary aspergillosis (ABPA) can present unusually. This case highlights ABPA causing acute hypoxemic respiratory failure due to lung collapse, a previously undocumented presentation.
Area of Science:
- Pulmonology
- Immunology
- Radiology
Background:
- Allergic bronchopulmonary aspergillosis (ABPA) is an immune response to Aspergillus fumigatus, often seen in asthma and cystic fibrosis patients.
- Common radiological findings include transient opacities, bronchiectasis, and mucoid impaction.
Observation:
- A 22-year-old female presented with acute hypoxemic respiratory failure.
- The patient experienced left lung collapse requiring rigid bronchoscopy.
Findings:
- The patient was diagnosed with ABPA.
- This represents the first reported instance of ABPA presenting as acute hypoxemic respiratory failure secondary to lung collapse.
Implications:
- This case expands the spectrum of radiological manifestations of ABPA.
- Clinicians should consider ABPA in patients with unexplained lung collapse and respiratory failure.
- Highlights the importance of considering uncommon presentations in diagnosing complex allergic lung diseases.
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