[Case of allergic bronchopulmonary aspergillosis complicated with lung abscess which developed into a bronchopleural fistula].
We report a case of bronchopleural fistula in a patient with allergic bronchopulmonary aspergillosis. A 25-year-old man was admitted with high fever and chest pain. Although his chest CT in a previous hospital showed pulmonary infiltrate suggesting the existence of a mucous plug, a mass shadow in the right upper lobe was recognized on admission to our hospital. Based on the presence of eosinophilia, elevated levels of total IgE and Aspergillus-specific IgE, positive precipitating antibody to Aspergillus, and detection of A. fumigatus in bronchial washing fluid, we diagnosed this case as ABPA complicated with lung abscess. Although we treated by antibiotics and antifungal drugs, the lung abscess did not improve and led to bronchopleural fistula. After addition of nebulised liposomal amphotericin B, his symptoms improved and treatment was successful.
Hara
Asae
A
Department of Medicine, Teikyo University School of Medicine.
Nagase
Hiroyuki
H
Hayashi
Hidetoshi
H
Kuramochi
Michio
M
Ishida
Hirofumi
H
Adachi
Tetsuya
T
Suzuki
Naohito
N
Ohta
Ken
K
D000280:Administration, Inhalation; D000328:Adult; D000666:Amphotericin B / Q000008:administration & dosage; D000935:Antifungal Agents / Q000008:administration & dosage; D001229:Aspergillosis, Allergic Bronchopulmonary / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D001983:Bronchial Fistula / Q000209:etiology*; D005402:Fistula / Q000209:etiology*; D006801:Humans; D008081:Liposomes; D008169:Lung Abscess / Q000209:etiology* / Q000628:therapy; D008297:Male; D010995:Pleural Diseases / Q000209:etiology*; D016896:Treatment Outcome
D000935:Antifungal Agents; D008081:Liposomes; D000666:Amphotericin B