Abstract
Background. Allergic bronchopulmonary aspergillosis (ABPA) commonly occurs in patients with cystic fibrosis (CF) in Western countries. However, in Japan, the prevalence of CF is very low. Although there are many patients who present with non-CF bronchiectasis, a clinical entity similar to CF, only a few reports have described such patients developing ABPA. Case. A 61-year-old man with bronchiectasis had been visiting our hospital for a long time. Pseudomonas aeruginosa was persistently detected in his sputum. During the course of the disease, he presented with wheezing and yellow sputum resembling a mucus plug. His peripheral blood tests indicated hypereosinophilia, an elevated serum IgE level, and positive precipitating antibodies against Aspergillus fumigatus. Chest X-ray showed new infiltrative shadows in the right lower lung region. Bronchoalveolar lavage showed an increase in eosinophils. A histological examination of the transbronchial biopsy revealed peribronchial and interstitial eosinophilic infiltration. Based on these findings, he was diagnosed with ABPA. Oral corticosteroid treatment was initiated, resulting in a favorable response despite chronic Pseudomonas aeruginosa infection. During steroid tapering, recurrence and pulmonary infections were observed. After recovering from the complications, the patient maintained long-term remission. Conclusion. We encountered a rare case of ABPA in a patient with non-CF bronchiectasis.
