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变应性支气管肺曲霉病中的短暂性肺部浸润被误诊为肺结核。

"Fleeting pulmonary infiltrates in allergic bronchopulmonary aspergillosis" Misdiagnosed as tuberculosis.

作者信息

Patil Shital, Patil Rajesh

机构信息

Department of Pulmonary Medicine, MIMSR Medical College, Latur, Maharashtra, India.

Department of Internal Medicine, MIMSR Medical College, Latur, Maharashtra, India.

出版信息

Int J Mycobacteriol. 2018 Apr-Jun;7(2):186-190. doi: 10.4103/ijmy.ijmy_57_18.

Abstract

Allergic bronchopulmonary aspergillosis (ABPA) is underdiagnosed and underevaluated routinely because of clinical and radiological overlap with tuberculosis (TB), especially in tropical setting with high TB burden countries like India. ABPA is the best-recognized manifestation of Aspergillus-associated hypersensitivity to Aspergillus antigens in patients with long-standing atopic asthma. ABPA with varied clinical presentation has been reported to occur in 20% of asthmatic patients admitted to hospitals and in 5% of all rhinitis cases. In this case report, we documented middle age male with known asthma case for many years with constitutional symptoms such as cough, fever, and shortness of breath diagnosed as TB and received anti-TB treatment for 4 weeks. Finally, we confirmed as a case of ABPA and documented complete clinical and radiological response to medical treatment with antifungals and systemic corticosteroids.

摘要

变应性支气管肺曲霉病(ABPA)由于其临床和影像学表现与结核病(TB)存在重叠,常规情况下常被漏诊和评估不足,尤其是在像印度这样结核病负担较高的热带地区。ABPA是长期特应性哮喘患者对曲霉抗原发生曲霉相关超敏反应最常见的表现形式。据报道,临床表现多样的ABPA在住院哮喘患者中发生率为20%,在所有鼻炎病例中发生率为5%。在本病例报告中,我们记录了一名患有多年哮喘病史的中年男性,出现咳嗽、发热和呼吸急促等全身症状,最初被诊断为结核病并接受了4周的抗结核治疗。最终,我们确诊其为ABPA病例,并记录了抗真菌药物和全身用糖皮质激素治疗后临床和影像学完全缓解的情况。

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