Rasheed Waqas, Tasnim Saria, Dweik Anass, Al-Jabory Ola, Usala Stephen
Internal Medicine, Texas Tech University Health Sciences Center, Amarillo, USA.
Cureus. 2022 Aug 20;14(8):e28202. doi: 10.7759/cureus.28202. eCollection 2022 Aug.
Allergic bronchopulmonary aspergillosis (ABPA) results from a hypersensitivity reaction to colonization of airways in patients with asthma or cystic fibrosis. Our patient is a 47-year-old female with a history of asthma and nonadherence to medications who presented with frequent asthma exacerbations. She required intubation three times within six months, labeled as asthma exacerbation due to nonadherence to medications until she was finally diagnosed with and successfully treated for ABPA. She was tested for ABPA very late as the medication nonadherence was thought to be the sole cause of repeated asthma exacerbations during previous hospitalizations. This case illustrates the importance of maintaining a high index of suspicion for ABPA in recurrent asthma exacerbation even in the setting of medical nonadherence.
变应性支气管肺曲霉病（ABPA）是由哮喘或囊性纤维化患者气道定植曲霉后发生的超敏反应所致。我们的患者是一名47岁女性，有哮喘病史且不遵医嘱用药，频繁出现哮喘急性加重。她在6个月内3次需要插管，之前一直被诊断为因不遵医嘱用药导致的哮喘急性加重，直到最终被诊断为ABPA并成功治疗。由于之前住院期间认为不遵医嘱用药是反复哮喘急性加重的唯一原因，她很晚才接受ABPA检测。这个病例说明了即使在存在不遵医嘱用药的情况下，对于反复哮喘急性加重患者，保持对ABPA的高度怀疑指数的重要性。
