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An "alternative" clinical course of COPD exacerbation and pulmonary embolism.
[allergic bronchopulmonary aspergillosis]
Patients
with
chronic
diseases
,
such
as
Chronic
Obstructive
Pulmonary
Disease
(
COPD
)
and
diabetes
mellitus
,
are
exposed
to
particular
complications
that
require
a
careful
diagnostic
algorithm
.
Pulmonary
Embolism
(
PE
)
in
COPD
patients
often
demands
an
accurate
differential
diagnosis
and
a
prompt
therapeutic
intervention
.
Aspergillus
spp
.
infection
comprises
a
large
spectrum
of
pathological
manifestations
,
depending
on
immune
status
and
the
presence
of
underlying
lung
disease
.
These
manifestations
may
range
from
invasive
pulmonary
aspergillosis
(
IPA
)
in
gravely
immunocompromised
patients
,
to
chronic
necrotizing
aspergillosis
(
CNA
)
in
patients
with
chronic
lung
diseases
and
moderately
compromised
immune
systems
.
Aspergilloma
is
generally
observed
in
patients
with
cavitary
lung
diseases
,
and
allergic
bronchopulmonary
aspergillosis
(
ABPA
)
is
reported
in
patients
with
hypersensitivity
to
Aspergillus
antigens
.
We
report
a
case
with
pulmonary
aspergillosis
arisen
on
a
pulmonary
infarction
after
PE
in
a
patient
with
COPD
and
diabetes
mellitus
.
To
date
,
report
with
this
clinical
evolution
was
not
reported
in
literature
.
This
report
is
intended
to
describe
an
accurate
diagnostic
path
in
a
complex
overlap
of
different
pathological
conditions
,
highlighting
the
great
importance
of
differential
diagnosis
and
an
appropriate
diagnostic
algorithm
.
In
addition
,
open
issues
on
the
real
diagnostic
value
of
clinical
,
radiological
,
and
laboratory
features
for
COPD
exacerbation
,
PE
and
aspergillosis
have
been
discussed
.
Diseases
Validation
Diseases presenting
"moderately compromised immune systems"
symptom
allergic bronchopulmonary aspergillosis
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