[Allergic bronchopulmonary aspergillosis in a patient with diabetes mellitus as the only risk factor]

Allergic bronchopulmonary aspergillosis is a rare entity, caused by a hypersensitivity reaction of the immune system to Aspergillus fumigatus, characterized by the presence of pulmonary infiltrates, bronchiectasis and increased eosinophils in peripheral blood.

42-year-old male with diabetes mellitus, with poor adherence to treatment, went to the emergency room due to rapidly progressive dyspnea and severe hypoxemia, pneumonia and bilateral pleural effusion were evident, laboratory studies reported, HbA1c 9.4%, eosinophils 3650 cells/mL, serum IgE for Aspergillus fumigatus 0.84 IU/mL. Treatment was started with supplemental oxygen, prednisone and itraconazole, to which the patient showed clinical and radiological improvement.

Invasive mycoses have a mortality of 21 to 80%, frequently in immunocompromised patients, they are usually not described in patients with diabetes mellitus; The prevalence of fungal colonization among diabetic patients has been described as 37% compared to 4.7% in non-diabetic patients.