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Allergic Bronchopulmonary Aspergillosis Presenting as Pyopneumothorax: Expanding the Clinical Spectrum
Jitendra Kumar Saini1, Yasir V Abdullah2, Shibani Modi3
1Department of Thoracic Oncology, National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India.
Annals of African Medicine
|December 1, 2025
Summary
Allergic bronchopulmonary aspergillosis (ABPA) can present as pyo-pneumothorax in asthmatic patients. Early diagnosis and combined corticosteroid-antifungal treatment are crucial for favorable outcomes in this rare complication.
Area of Science:
- Pulmonology
- Allergy and Immunology
- Infectious Diseases
Background:
- Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity reaction to Aspergillus fumigatus.
- Pleural involvement in ABPA is rare, with pyo-pneumothorax being an exceptionally uncommon manifestation.
Purpose of the Study:
- To report a rare case of ABPA presenting with pyo-pneumothorax.
- To highlight the importance of recognizing pleural involvement in ABPA management.
Main Methods:
- Case report of a 23-year-old female with asthma.
- Diagnostic criteria included elevated IgE, specific IgE/IgG antibodies to A. fumigatus, and imaging findings.
- Management involved systemic corticosteroids and itraconazole.
Main Results:
- The patient presented with pyo-pneumothorax, bronchial obstruction by mucus plug, and bronchiectasis.
- Markedly elevated IgE levels and positive A. fumigatus antibodies confirmed ABPA.
- Treatment led to significant symptomatic and radiological improvement.
Conclusions:
- Pyo-pneumothorax is a potential, albeit rare, presentation of ABPA.
- Early recognition and multidisciplinary management are vital for preventing morbidity.
- Clinicians should consider ABPA in asthmatics with pleural disease, elevated IgE, and bronchiectasis.
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