“…Despite the similar mechanism of colonization, few cases report simultaneous presence of both diseases [9]. Patients at risk for developing AAS include those with a prior sensitization to the Aspergillus antigen who also have a past medical history of asthma or rhinosinusitis [10].…”
Aspergillosis refers to a spectrum of disorders that can occur due to colonization with the Aspergillus fungus. Allergic bronchopulmonary aspergillosis (ABPA) is an airway hypersensitivity reaction to the fungus that is almost exclusively seen in patients with cystic fibrosis or asthma. Here, we present a case of ABPA in a patient with a history of chronic cocaine use and tuberculosis and no history of asthma or cystic fibrosis. The patient had presented with progressively worsening dyspnea for three months as well as a 20-pound weight loss. Diagnosis was made with an elevated IgE against Aspergillus and chest CT findings, which included bronchiectasis and tree-in-bud nodular opacities. The patient was treated with IV methylprednisolone followed by a 4-day course of oral prednisone, with significant improvement. It is our hope to make healthcare providers aware of the potential presence of ABPA in chronic cocaine users and patients with tuberculosis, both of which are not traditionally associated with this condition.
“…Despite the similar mechanism of colonization, few cases report simultaneous presence of both diseases [9]. Patients at risk for developing AAS include those with a prior sensitization to the Aspergillus antigen who also have a past medical history of asthma or rhinosinusitis [10].…”
Aspergillosis refers to a spectrum of disorders that can occur due to colonization with the Aspergillus fungus. Allergic bronchopulmonary aspergillosis (ABPA) is an airway hypersensitivity reaction to the fungus that is almost exclusively seen in patients with cystic fibrosis or asthma. Here, we present a case of ABPA in a patient with a history of chronic cocaine use and tuberculosis and no history of asthma or cystic fibrosis. The patient had presented with progressively worsening dyspnea for three months as well as a 20-pound weight loss. Diagnosis was made with an elevated IgE against Aspergillus and chest CT findings, which included bronchiectasis and tree-in-bud nodular opacities. The patient was treated with IV methylprednisolone followed by a 4-day course of oral prednisone, with significant improvement. It is our hope to make healthcare providers aware of the potential presence of ABPA in chronic cocaine users and patients with tuberculosis, both of which are not traditionally associated with this condition.
“…A excisão cirúrgica é recomendada apenas quando a intervenção radiológica especializada não está disponível ou na presença de processo destrutivo considerável no pulmão. (4,5) Em resumo, embora o aspergiloma seja a causa mais comum de nódulo intracavitário em pacientes com tuberculose, o diagnóstico diferencial deve ser feito com outras afecções, especialmente o AR. A precocidade no diagnóstico possibilita o emprego de terapêutica adequada, reduzindo riscos de morte por sangramento maciço.…”
Section: Ao Editorunclassified
“…Surgical excision is recommended when specialized radiological procedures are unavailable or when there is considerable lung destruction. 4 , 5 …”
“…Most affected cavities are in the upper lobes, reflecting associations with TB and sarcoidosis. Aspergillomas are usually single, although some are multiple [1,5,6,12,13].…”
Aspergilloma, also known as mycetoma or fungus ball, is characterized by a round or oval mass with soft-tissue attenuation within a preexisting lung cavity. The typical computed tomography (CT) aspect of an aspergilloma is a mass separated from the wall of the cavity by an airspace of variable size and shape, resulting in the air crescent sign, also known as the meniscus sign. This CT feature is non-specific and can be simulated by several other entities that result in intracavitary masses. This review describes the main clinical and imaging aspects of the infectious and non-infectious diseases that may present with fungus-ball appearance, including pulmonary hydatid cyst, Rasmussen aneurysm, pulmonary gangrene, intracavitary clot, textiloma, lung cancer, metastasis, and teratoma, focusing on the differential diagnosis.
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