Middle lobe syndrome: a rare presentation of allergic bronchopulmonary aspergillosis.

[allergic bronchopulmonary aspergillosis]

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 .