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Allergic bronchopulmonary aspergillosis with repeated isolation of nontuberculous mycobacteria.
[allergic bronchopulmonary aspergillosis]
A
68
-
year
-old
woman
without
asthma
presented
with
a
cough
and
abnormal
shadows
on
a
chest
X-
ray
.
Computed
tomography
showed
right
middle
lobe
atelectasis
and
centrilobular
nodules
with
a
tree-
in
-
bud
appearance
in
the
other
lobes
.
The
patient
's
sputum
repeatedly
yielded
positive
cultures
of
nontuberculous
mycobacteria
(
NTM
)
;
however
,
no
fungi
were
detected
.
A
transbronchial
biopsy
showed
allergic
mucin
with
eosinophils
,
although
the
findings
were
not
diagnostic
.
We
suspected
that
the
patient
had
pulmonary
mycobacteriosis
;
however
,
treatment
for
this
condition
failed
.
We
then
performed
thoracoscopy
for
further
evaluation
and
treatment
of
the
NTM
infection
.
The
resected
specimen
obtained
from
the
right
middle
lobe
exhibited
the
characteristic
findings
of
allergic
bronchopulmonary
mycosis
without
evidence
of
mycobacterial
infection
.
The
administration
of
corticosteroids
and
itraconazole
resulted
in
improvement
of
the
patient
's
condition
.
The
NTM
appeared
to
be
simply
a
coincidental
colonization
of
the
resected
middle
lobe
bronchus
.
The
absence
of
asthma
,
the
inability
to
isolate
fungi
and
the
repeated
isolation
of
NTM
made
it
difficult
to
differentiate
allergic
bronchopulmonary
aspergillosis
from
NTM
infection
.
Diseases
Validation
Diseases presenting
"then performed thoracoscopy"
symptom
allergic bronchopulmonary aspergillosis
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