Lin Zhuangheng, Su Weiming, Wu Dinghui, Lin Yangkun, Jian Lijuan, He Zigang, Jiang Dandan
Department of Pulmonary Medicine, Xinglin Hospital of Xiamen, Xiamen, China.
Front Med (Lausanne). 2025 Jul 24;12:1591707. doi: 10.3389/fmed.2025.1591707. eCollection 2025.
Herein, we report a case of allergic bronchopulmonary aspergillosis (ABPA) complicated by infection. A 73-year-old man with a history of duodenal ulcer perforation and prior Billroth II gastrectomy presented with a 14-year history of recurrent cough and wheezing, recently accompanied by new gastrointestinal symptoms. He was initially diagnosed with chronic obstructive pulmonary disease (COPD). Subsequent laboratory evaluation revealed a markedly elevated total serum IgE (1,219 kUA/L) and increased -specific IgE (0.38 kUA/L, positive cutoff >0.35 kUA/L), leading to a diagnosis of ABPA. Despite antifungal and corticosteroid therapy, total IgE levels remained persistently elevated, accompanied by worsening gastrointestinal symptoms. Multiple stool examinations failed to detect parasitic infection. As gastrointestinal symptoms progressed, gastroscopy revealed the presence of parasitic eggs and larvae. Subsequently, a stool specimen was sent to the Xiamen Center for Disease Control and Prevention. Using the formol-ether concentration technique, the microscopic examination ultimately confirmed an infection with . Following albendazole treatment, the patient's symptoms completely resolved. In conclusion, co-infection of ABPA with may lead to missed or delayed diagnosis due to persistently elevated IgE levels.
在此，我们报告一例合并感染的变应性支气管肺曲霉病（ABPA）病例。一名73岁男性，有十二指肠溃疡穿孔病史且曾行毕Ⅱ式胃切除术，有14年反复咳嗽和喘息病史，近期伴有新出现的胃肠道症状。他最初被诊断为慢性阻塞性肺疾病（COPD）。随后的实验室检查显示血清总IgE显著升高（1219 kUA/L）且特异性IgE升高（0.38 kUA/L，阳性临界值>0.35 kUA/L），从而诊断为ABPA。尽管进行了抗真菌和糖皮质激素治疗，但总IgE水平持续升高，同时胃肠道症状加重。多次粪便检查未检测到寄生虫感染。随着胃肠道症状进展，胃镜检查发现有寄生虫卵和幼虫。随后，一份粪便标本被送至厦门市疾病预防控制中心。采用甲醛乙醚浓缩技术，显微镜检查最终确诊感染了 。使用阿苯达唑治疗后，患者症状完全缓解。总之，ABPA合并 感染可能因IgE水平持续升高导致诊断漏诊或延误。
