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Middle lobe syndrome: a rare presentation of allergic bronchopulmonary aspergillosis

A Shah1, S Behera1, C Panjabi2

  • 1Department of Respiratory Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi 110 007, India.

European Annals of Allergy and Clinical Immunology
|July 24, 2014
PubMed

Insights

Allergic bronchopulmonary aspergillosis (ABPA) can uncommonly cause middle lobe syndrome (MLS). This case highlights a rare presentation of ABPA mimicking non-resolving pneumonia, successfully treated with corticosteroids.

Area of Science:

  • Pulmonology
  • Allergy and Immunology
  • Infectious Diseases

Background:

  • Allergic bronchopulmonary aspergillosis (ABPA) is a lung disease caused by hypersensitivity to Aspergillus species in asthmatic individuals.
  • Mucoid impaction leading to lobar or segmental collapse is a known complication of ABPA.
  • Middle lobe syndrome (MLS) as a manifestation of ABPA is considered rare.

Observation:

  • A 36-year-old male presented with symptoms suggestive of a non-resolving pneumonia.
  • Imaging revealed findings consistent with MLS and central bronchiectasis.
  • The patient met diagnostic criteria for ABPA.

Findings:

  • The patient's condition was diagnosed as MLS secondary to ABPA.
  • Treatment with oral corticosteroids led to significant symptom improvement.

Implications:

  • This case underscores the importance of considering ABPA in the differential diagnosis of middle lobe syndrome, even in atypical presentations.
  • Early diagnosis and treatment of ABPA-associated MLS can lead to favorable outcomes.
  • Further research may elucidate the mechanisms behind this uncommon association.
Keywords:
Allergic bronchopulmonary aspergillosisAspergillusbronchial asthmacentral bronchiectasismiddle lobe syndrome

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