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BMJ Case Rep. 2014 May 26;2014. pii: bcr2013202428. doi: 10.1136/bcr-2013-202428.

Uncontrolled asthma and recurring pulmonary opacities: just asthma?

Author information

1
Department of Medicine, Odense University Hospital-Svendborg Hospital, Svendborg, Denmark.
2
Division of Respiratory Medicine, Littlebelt Hospital, Fredericia, Denmark.
3
Department of Respiratory Medicine, Odense University Hospital, Odense, Denmark.

Abstract

In asthma, when comorbidities and common causes of poor control have been considered and treated, the clinician may speculate, 'Is it all asthma?'. In patients with uncontrolled atopic asthma with recurring episodes of symptoms mimicking pneumonia, the suspicion of allergic bronchopulmonary aspergillosis (ABPA) should remain high. ABPA is caused by a complex immunological hypersensitivity reaction to colonisation with Aspergillus fumigatus in the bronchial tree, and is characterised by the presence of atopic asthma, blood eosinophilia, migrating pulmonary opacities and potential bronchiectasis. This case report describes a delay in diagnosing ABPA which was imitating pneumonia. The clinician should pay increased attention to ABPA and test for this in patients with uncontrolled asthma with an ongoing requirement for oral corticosteroids and/or antibiotics and with pulmonary opacities on chest imaging.

PMID:
24862414
PMCID:
PMC4039853
DOI:
10.1136/bcr-2013-202428
[Indexed for MEDLINE]
Free PMC Article
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