title: A case report of Aspergillus hypersensitivity syndrome with obstructing bronchial aspergillosis.
abstract: 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.
authors.affiliation: Department of Respiratory Medicine, Tan Tock Seng Hospital, Singapore.
authors.forename: P
authors.initials: P
authors.lastname: Lee
authors.forename: S K
authors.initials: SK
authors.lastname: Goh
authors.forename: W M
authors.initials: WM
authors.lastname: Yap
authors.forename: C C
authors.initials: CC
authors.lastname: Chan
mesh_terms: 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
chemical_list: D000935:Antifungal Agents