Abstract
A 67-year-old man was admitted to our hospital with complaints of cough, excessive sputum and dyspnea. Increased erythrocyte sedimentation rate and marked eosinophilia in peripheral blood (26%) were observed. Chest X-rays showed infiltrates in the lower paramediastinal field of the right lung. Tomograms showed central bronchiectasis in the infiltrated area.
Using Aspergillus fumigatus antigens, positive immediate and Arthus skin reactions and serum precipitins were demonstrated. Serum IgE (ETA) was elevated (50, 321IU/ml) and Aspergillus-specific IgE (BAST) antibody was positive. Sputum cultures revealed A. fumigatus.
These findings were consistent with a diagnosis of allergic bronchopulmonary aspergillosis (ABPA).
The patient probably had been suffering from ABPA for more than 22 years according to retrospective observations of his chest films.
