Clinical Analysis of Allergic Bronchopulmonary Aspergillosis Misdiagnosed as Bronchial Asthma

MEI Zhou-fang; QIAN Ling; DU Yong; SHI Jin-dong; HE Wei; JIE Zhi-jun

doi:10.3969/j.issn.1002-3429.2015.02.015

Abstract：Objective To analyze the clinical characteristics of allergic bronchial pulmonary aspergillosis and its di-agnosis methods, so as to reduce misdiagnosis rate. Methods One case of allergic bronchial pulmonary aspergillosis in our hospital misdiagnosed as bronchial asthma was retrospectively analyzed, and relevant literatures were reviewed. Results The patient was admitted for paroxysmal cough for 5 years and aggravated asthma for half a month. The patient was treated for bron-chial asthma but without any improvement. Upon admission to our hospital, the bronchi relaxation and pulmonary function were tested positive, and the patient was diagnosed as having acute bronchial asthma. But the result of corresponding treatment was not satisfactory. Chest CT scanning showed central bronchiectasis;aspergillus was found in sputum culture;GM test was positive, and serum immunoglobulin E ( IgE 1910 U/ml) was tested. For clinical symptoms the patient was diagnosed as hav-ing allergic bronchial pulmonary aspergillosis. After treatment of oral voriconazole in combination with hormone for 3 weeks, symptoms were relieved significantly, sputum aspergillus turned negtive. Conclusion Patients presenting asthma symptoms with poor clinical effectiveness should be highly suspected for allergic bronchial pulmonary aspergillosis, and imaging examina-tion, serum immunoglobulin E, bacteria sputum smear examinations have important significance in diagnosis.