异常共存:过敏性支气管肺曲菌病与肺结核-罕见病例报告

Ankit Kumar, L. Devi, Y. Verma, Parul Sharma, A. Ahmad, Shubham Chandra
{"title":"异常共存:过敏性支气管肺曲菌病与肺结核-罕见病例报告","authors":"Ankit Kumar, L. Devi, Y. Verma, Parul Sharma, A. Ahmad, Shubham Chandra","doi":"10.18231/j.ijirm.2023.008","DOIUrl":null,"url":null,"abstract":": Allergic Bronchopulmonary Aspergillosis (ABPA) is an allergic hypersensitivity reaction to the ubiquitous fungus Aspergillus that can cause inflammation and damage to the respiratory system. This condition predominantly occurs in individuals with long-standing airway disease, such as bronchial asthma or cystic fibrosis. While Acid-fast bacilli Mycobacterium tuberculosis causes tuberculosis (TB). ABPA and TB can coexist in the same patient. The coexistence of these two conditions can make the diagnosis and treatment more challenging. This is because some of the symptoms of ABPA, such as cough and wheezing, can be similar to those of TB, and both conditions can cause lung damage. A 21-year young male was admitted with a six-month history of low-grade fever, cough with expectoration, atypical chest pain, and progressive breathlessness. On examination, the patient had bilateral diffuse rhonchi with coarse crepitation, and his chest X-ray showed bilateral heterogeneous opacities with cavities in the left upper and middle zone. Further evaluation revealed a total serum IgE of 3074 IU/L (Normal <100) and elevated levels of Aspergillus fumigatus-specific IgE and IgG. A high-resolution CT of the thorax revealed bilateral upper lobes with tree-in-bud opacities and centrilobular nodules, leading to a diagnosis of ABPA. A sputum sample was sent for an AFB smear, which was positive.Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity reaction to Aspergillus fumigatus that most commonly affects people who have bronchial asthma or cystic fibrosis. However, diagnosis can be challenging as patients may not respond to standard treatment, and the symptoms can overlap with those of other respiratory diseases. Therefore, clinicians need to maintain a high index of suspicion for ABPA in at-risk patients and consider appropriate screening tests.This case highlights the rare co-existence of active pulmonary TB and ABPA, which can make diagnosis and treatment challenging. However, with appropriate management, including anti-tubercular treatment and corticosteroid therapy, the patient showed marked improvement in his condition. Clinicians should consider the possibility of multiple comorbidities in patients presenting with respiratory symptoms, and appropriate evaluation and management should be undertaken to achieve optimal outcomes.","PeriodicalId":14503,"journal":{"name":"IP Indian Journal of Immunology and Respiratory Medicine","volume":"43 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2023-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Unusual coexistence: Allergic bronchopulmonary aspergillosis and pulmonary tuberculosis- A rare case report\",\"authors\":\"Ankit Kumar, L. Devi, Y. Verma, Parul Sharma, A. Ahmad, Shubham Chandra\",\"doi\":\"10.18231/j.ijirm.2023.008\",\"DOIUrl\":null,\"url\":null,\"abstract\":\": Allergic Bronchopulmonary Aspergillosis (ABPA) is an allergic hypersensitivity reaction to the ubiquitous fungus Aspergillus that can cause inflammation and damage to the respiratory system. This condition predominantly occurs in individuals with long-standing airway disease, such as bronchial asthma or cystic fibrosis. While Acid-fast bacilli Mycobacterium tuberculosis causes tuberculosis (TB). ABPA and TB can coexist in the same patient. The coexistence of these two conditions can make the diagnosis and treatment more challenging. This is because some of the symptoms of ABPA, such as cough and wheezing, can be similar to those of TB, and both conditions can cause lung damage. A 21-year young male was admitted with a six-month history of low-grade fever, cough with expectoration, atypical chest pain, and progressive breathlessness. On examination, the patient had bilateral diffuse rhonchi with coarse crepitation, and his chest X-ray showed bilateral heterogeneous opacities with cavities in the left upper and middle zone. Further evaluation revealed a total serum IgE of 3074 IU/L (Normal <100) and elevated levels of Aspergillus fumigatus-specific IgE and IgG. A high-resolution CT of the thorax revealed bilateral upper lobes with tree-in-bud opacities and centrilobular nodules, leading to a diagnosis of ABPA. A sputum sample was sent for an AFB smear, which was positive.Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity reaction to Aspergillus fumigatus that most commonly affects people who have bronchial asthma or cystic fibrosis. However, diagnosis can be challenging as patients may not respond to standard treatment, and the symptoms can overlap with those of other respiratory diseases. Therefore, clinicians need to maintain a high index of suspicion for ABPA in at-risk patients and consider appropriate screening tests.This case highlights the rare co-existence of active pulmonary TB and ABPA, which can make diagnosis and treatment challenging. However, with appropriate management, including anti-tubercular treatment and corticosteroid therapy, the patient showed marked improvement in his condition. Clinicians should consider the possibility of multiple comorbidities in patients presenting with respiratory symptoms, and appropriate evaluation and management should be undertaken to achieve optimal outcomes.\",\"PeriodicalId\":14503,\"journal\":{\"name\":\"IP Indian Journal of Immunology and Respiratory Medicine\",\"volume\":\"43 1\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-05-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"IP Indian Journal of Immunology and Respiratory Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.18231/j.ijirm.2023.008\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"IP Indian Journal of Immunology and Respiratory Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.18231/j.ijirm.2023.008","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

当前位置过敏性支气管肺曲霉病(ABPA)是一种对无处不在的真菌曲霉的过敏性超敏反应,可引起炎症和呼吸系统损伤。这种情况主要发生在长期气道疾病的个体,如支气管哮喘或囊性纤维化。而抗酸杆菌结核分枝杆菌引起肺结核(TB)。ABPA和TB可以在同一患者中共存。这两种情况的共存会使诊断和治疗更具挑战性。这是因为ABPA的一些症状,如咳嗽和喘息,可能与结核病相似,这两种情况都可能导致肺部损伤。一位21岁的年轻男性因6个月的低烧、咳嗽伴咳痰、非典型胸痛和进行性呼吸困难入院。检查时,患者双侧弥漫性颈椎病伴粗鸣,胸部x线示双侧不均匀性混浊影,左侧上、中部有空腔。进一步检查发现血清总IgE为3074 IU/L(正常<100),烟曲霉特异性IgE和IgG水平升高。胸部高分辨率CT显示双侧上叶树状芽状影和小叶中心结节,诊断为ABPA。痰样本被送去做AFB涂片,结果呈阳性。过敏性支气管肺曲霉病(ABPA)是一种对烟曲霉的超敏反应,最常见于支气管哮喘或囊性纤维化患者。然而,诊断可能具有挑战性,因为患者可能对标准治疗没有反应,并且症状可能与其他呼吸系统疾病的症状重叠。因此,临床医生需要对高危患者的ABPA保持高度的怀疑指数,并考虑适当的筛查试验。本病例突出了活动性肺结核和ABPA共存的罕见情况,这给诊断和治疗带来了挑战。然而,通过适当的管理,包括抗结核治疗和皮质类固醇治疗,患者的病情明显改善。临床医生应考虑出现呼吸道症状的患者出现多种合并症的可能性,并应进行适当的评估和管理,以达到最佳结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Unusual coexistence: Allergic bronchopulmonary aspergillosis and pulmonary tuberculosis- A rare case report
: Allergic Bronchopulmonary Aspergillosis (ABPA) is an allergic hypersensitivity reaction to the ubiquitous fungus Aspergillus that can cause inflammation and damage to the respiratory system. This condition predominantly occurs in individuals with long-standing airway disease, such as bronchial asthma or cystic fibrosis. While Acid-fast bacilli Mycobacterium tuberculosis causes tuberculosis (TB). ABPA and TB can coexist in the same patient. The coexistence of these two conditions can make the diagnosis and treatment more challenging. This is because some of the symptoms of ABPA, such as cough and wheezing, can be similar to those of TB, and both conditions can cause lung damage. A 21-year young male was admitted with a six-month history of low-grade fever, cough with expectoration, atypical chest pain, and progressive breathlessness. On examination, the patient had bilateral diffuse rhonchi with coarse crepitation, and his chest X-ray showed bilateral heterogeneous opacities with cavities in the left upper and middle zone. Further evaluation revealed a total serum IgE of 3074 IU/L (Normal <100) and elevated levels of Aspergillus fumigatus-specific IgE and IgG. A high-resolution CT of the thorax revealed bilateral upper lobes with tree-in-bud opacities and centrilobular nodules, leading to a diagnosis of ABPA. A sputum sample was sent for an AFB smear, which was positive.Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity reaction to Aspergillus fumigatus that most commonly affects people who have bronchial asthma or cystic fibrosis. However, diagnosis can be challenging as patients may not respond to standard treatment, and the symptoms can overlap with those of other respiratory diseases. Therefore, clinicians need to maintain a high index of suspicion for ABPA in at-risk patients and consider appropriate screening tests.This case highlights the rare co-existence of active pulmonary TB and ABPA, which can make diagnosis and treatment challenging. However, with appropriate management, including anti-tubercular treatment and corticosteroid therapy, the patient showed marked improvement in his condition. Clinicians should consider the possibility of multiple comorbidities in patients presenting with respiratory symptoms, and appropriate evaluation and management should be undertaken to achieve optimal outcomes.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
期刊最新文献
Artificial intelligence in tuberculosis diagnosis: Revolutionizing detection and treatment A closer look -Asymptomatic cysticercosis unveiled during COPD exacerbation: A case report Think beyond TB lymphadenitis - Kikuchi fujimoto lymphadenitis Psychological manifestations in patients with tuberculosis: prevalence and contributing factors Evaluation of impact of adherence to inhaled therapy and critical mistakes in inhalation technique on clinical outcomes in patients with obstructive airway diseases in India
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1