Allergic Bronchopulmonary Aspergillosis in a Patient With Poorly Controlled Bronchial Asthma

Allergic bronchopulmonary aspergillosis (ABPA) is a notable complication in patients with chronic lung diseases, such as chronic bronchial asthma and cystic fibrosis, presenting challenges in diagnosis and management. ABPA is an allergic response to multiple antigens expressed by Aspergillus fumigatus in the lung mucosa, resulting in airway inflammation and damage. This study discusses a 58-year-old male patient with a history of longstanding bronchial asthma for 28 years who presented with worsening respiratory symptoms. The patient's blood investigations showed peripheral eosinophilia, increased total serum immunoglobulin IgE, and positive Aspergillus serology. Bronchoalveolar lavage samples showed a significant increase in Aspergillus antigens, along with positive radiological findings, leading to the diagnosis of ABPA. He was successfully treated with a combination of dual antifungal therapy, systemic corticosteroids, inhaled corticosteroids, and bronchodilators. This study emphasizes the importance of considering ABPA in patients with chronic bronchial asthma experiencing deteriorating respiratory symptoms and highlights the significance of a multidisciplinary approach for accurate diagnosis and effective management of this condition.