Department of Pulmonary Medicine, All India Institute of Medical Education and Research, Rishikesh, India.
Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
BMJ Case Rep. 2021 May 24;14(5):e242915. doi: 10.1136/bcr-2021-242915.
A 25-year-old man, who was taking treatment for his poorly controlled asthma, presented with symptoms of cough with expectoration, gradually progressive shortness of breath, fever on and off and diffuse wheeze for 2 years. Chest X-ray revealed hyperinflation of lung field with dense opacification at right upper lobe. High-resolution CT chest showed bilateral patchy consolidation, central bronchiectasis and high-attenuation mucus (HAM) impaction. His blood absolute eosinophil count, total serum IgE level, specific IgE and IgG level were 1910, 16760 kU/L, 59.8 kU/L and 147.41 kU/L, respectively. Diagnosis of allergic broncho pulmonary aspergillosis (ABPA) was established according to International Society for Human and Animal Mycology society guidelines. He was started on systemic steroids and doing well after 6 months of follow-up. Our case illustrates HAM, which is a rare but typical radiological feature of ABPA.
一位 25 岁男性，因未控制的哮喘正在接受治疗，出现咳嗽伴咳痰、逐渐加重的呼吸困难、间歇性发热和弥漫性哮鸣音 2 年。胸部 X 线显示肺部过度充气，右上叶有致密混浊。高分辨率 CT 胸部显示双侧斑片状实变、中央支气管扩张和高衰减黏液（HAM）嵌塞。他的血绝对嗜酸性粒细胞计数、总血清 IgE 水平、特异性 IgE 和 IgG 水平分别为 1910、16760 kU/L、59.8 kU/L 和 147.41 kU/L。根据国际人类和动物真菌学会的指南，诊断为变应性支气管肺曲霉病（ABPA）。他开始接受全身类固醇治疗，随访 6 个月后情况良好。我们的病例说明了 HAM，这是 ABPA 的一种罕见但典型的放射学特征。
