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 .

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Diseases presenting "the inability to isolate fungi and the repeated isolation of ntm made it difficult to differentiate allergic bronchopulmonary aspergillosis from ntm infection" symptom

allergic bronchopulmonary aspergillosis

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