A case report of Aspergillus hypersensitivity syndrome with obstructing bronchial aspergillosis.
BACKGROUND
A 62-year-old Indian male with diabetes mellitus presented with atypical, overlap features of Aspergillus hypersensitivity syndrome and obstructing bronchial aspergillosis.


METHODS
He was febrile and tachypnoeic with diffuse crepitations and wheezing. Chest X-ray was normal but eosinophil count was 2900/mm3 and Ig E > 10,000 IU/ml.


RESULTS
He responded initially to high dose steroid therapy but deteriorated subsequently from extensive mucus plugging of the bronchial tree which resulted in respiratory failure and death. He was HIV-negative.


CONCLUSIONS
Culture and histologic examination of bronchoscopically identified tracheobronchial mucus plugs should be performed as early treatment may be life-saving.
Lee
P
P
Department of Respiratory Medicine, Tan Tock Seng Hospital, Singapore.
Goh
S K
SK
Yap
W M
WM
Chan
C C
CC
D000402:Airway Obstruction / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D000935:Antifungal Agents / Q000627:therapeutic use; D001229:Aspergillosis, Allergic Bronchopulmonary / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D001999:Bronchoscopy; D003937:Diagnosis, Differential; D018450:Disease Progression; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D008875:Middle Aged; D013577:Syndrome
D000935:Antifungal Agents