Indian Journal of Medical Research

CLINICAL IMAGE
Year
: 2020  |  Volume : 152  |  Issue : 7  |  Page : 241-

Allergic bronchopulmonary aspergillosis misdiagnosed & incorrectly treated as pulmonary tuberculosis


Surendra K Sharma1, Vishwanath Upadhyay2,  
1 Department of Internal Medicine, All India Institute of Medical Sciences, New Delhi 110 029; Department of Molecular Medicine, Jamia Hamdard (Deemed-to-be-University), New Delhi 110 062; Department of General Medicine & Respiratory Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Sawangi (M), Wardha 442 004, Maharashtra, India
2 Department of Molecular Medicine, Jamia Hamdard (Deemed-to-be-University), New Delhi 110 062, India

Correspondence Address:
Surendra K Sharma
Department of Internal Medicine, All India Institute of Medical Sciences, New Delhi 110 029; Department of Molecular Medicine, Jamia Hamdard (Deemed-to-be-University), New Delhi 110 062; Department of General Medicine & Respiratory Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Sawangi (M), Wardha 442 004, Maharashtra
India




How to cite this article:
Sharma SK, Upadhyay V. Allergic bronchopulmonary aspergillosis misdiagnosed & incorrectly treated as pulmonary tuberculosis.Indian J Med Res 2020;152:241-241


How to cite this URL:
Sharma SK, Upadhyay V. Allergic bronchopulmonary aspergillosis misdiagnosed & incorrectly treated as pulmonary tuberculosis. Indian J Med Res [serial online] 2020 [cited 2021 Sep 23 ];152:241-241
Available from: https://www.ijmr.org.in/text.asp?2020/152/7/241/316854


Full Text

A 22 yr old female† was referred to the department of Internal Medicine, All India Institute of Medical Sciences New Delhi, India, in November 2016, with a diagnosis of pulmonary tuberculosis which was not responding to treatment. On interrogation, she had a history of bronchial asthma since childhood. Chest X-ray [Figure 1]A and high-resolution computed tomography of the chest [Figure 1]B revealed bilateral upper lobe opacities (right>left) in the both lung fields. Other parameters were suggestive of allergic bronchopulmonary aspergillosis (ABPA) included absolute eosinophil count :1.86 X103/mm3 [(normal:0.02-0.50 electrical impedance; volume, conductivity, light scatter (VCS)]; Aspergillus fumigatus antibodies panel, IgG: >200 U/mL (reference range <8.0), IgM: 1.35 U/mL (reference range <8.00); A. fumigatus precipitins: 12.90 (kUA/L) (reference range <0.35) and, serum immunoglobulin IgE : 11,223.00 kUA/L (reference range <64) (FEIA). With the diagnosis of allergic bronchopulmonary aspergillosis (ABPA), she was treated with oral prednisolone 60 mg/day which was gradually tapered off over the next six months, itraconazole (200 mg twice daily) and inhalational bronchodilators (steroids and β agonists). She responded significantly to the treatment [Figure 1]C. She was put on metered-dose inhalers and is doing well on follow up till date. In this case, ABPA was misdiagnosed and incorrectly treated as pulmonary TB.{Figure 1}

Conflicts of Interest: None.