RESUMO
Allergic bronchopulmonary aspergillosis (ABPA) is a disease predominantly seen in susceptible asthmatic subjects, due to a hypersensitivity phenomenon caused by colonisation of the airways by Aspergillus species. Although collapse, both lobar and segmental due to mucoid impaction, is not uncommon in ABPA, a middle lobe syndrome (MLS) secondary to ABPA is rather an uncommon association. We report this rare and unusual clinical presentation in a 36-year-old male, who presented for evaluation of a "non resolving pneumonia". Imaging suggested the presence of a MLS and central bronchiectasis. Further investigations revealed that the patient met 6/8 of the essential diagnostic criteria for ABPA. Appropriate therapy with oral corticosteroids resulted in remarkable symptomatic improvement.
Assuntos
Aspergilose Broncopulmonar Alérgica/complicações , Síndrome do Lobo Médio/etiologia , Corticosteroides/uso terapêutico , Adulto , Aspergilose Broncopulmonar Alérgica/patologia , Aspergilose Broncopulmonar Alérgica/fisiopatologia , Humanos , Masculino , Síndrome do Lobo Médio/patologia , Síndrome do Lobo Médio/fisiopatologiaAssuntos
Hipersensibilidade/etiologia , Sêmen , Adulto , Idade de Início , Anti-Inflamatórios não Esteroides/uso terapêutico , Coito , Diagnóstico Diferencial , Feminino , Fertilização , Antagonistas dos Receptores Histamínicos H1/uso terapêutico , Humanos , Hipersensibilidade/imunologia , Hipersensibilidade/terapia , Imunoterapia , MasculinoAssuntos
Aspergilose Broncopulmonar Alérgica/diagnóstico , Aspergillus niger , Adulto , Aspergilose Broncopulmonar Alérgica/complicações , Aspergilose Broncopulmonar Alérgica/microbiologia , Asma/complicações , Diagnóstico Diferencial , Humanos , Masculino , Tuberculose Resistente a Múltiplos Medicamentos/diagnósticoRESUMO
A 55 years immunocompetent male was evaluated for chronic pulmonary disease of over 12-month duration for which he had twice been prescribed anti-tubercular therapy. Investigations led to the diagnosis of chronic Klebsiella pneumonia, which is rarely encountered in immunocompetent hosts in the antibiotic era.
Assuntos
Hospedeiro Imunocomprometido , Infecções por Klebsiella/complicações , Infecções por Klebsiella/diagnóstico , Klebsiella pneumoniae/isolamento & purificação , Pneumonia Bacteriana/diagnóstico , Pneumonia Bacteriana/etiologia , Doença Crônica , Humanos , Infecções por Klebsiella/terapia , Masculino , Pessoa de Meia-Idade , Pneumonia Bacteriana/terapiaRESUMO
A 22-year-old male, referred to us as a case of multi-drug resistant tuberculosis was diagnosed as allergic bronchopulmonary aspergillosis (ABPA) after serological and computed tomography confirmation. He was initiated on oral as well as inhaled corticosteroids along with nasal corticosteroid spray for his nasal complaints. One year subsequently, he developed a nasal septal perforation. Biopsy taken from the site did not reveal any granulomatous or atrophic changes and cultures of the biopsy did not yield any organism. The septal defect, repaired surgically by Hazeltine's method healed completely within 6 weeks. There have been anecdotal reports of septal perforation in patients with rhinitis on intranasal corticosteroids but hitherto not in patients with ABPA. A periodic examination of the nasal septum should be undertaken in patients with ABPA and rhinitis on long term inhaled oral and intranasal corticosteroids along with oral corticosteroids.