An atypical acute exacerbation of COPD due to Aspergillus fumigatus

  • Cuneyt Tetikkurt | tetikkurt@gmail.com Department of Pulmonary Medicine, Cerrahpasa Medical Faculty, Istanbul Cerrahpasa University, Turkey. http://orcid.org/0000-0002-4122-2908
  • Bahar Kubat Department of Pulmonary Medicine, Cerrahpasa Medical Faculty, Istanbul Cerrahpasa University, Turkey.
  • Seza Tetikkurt Pathology Department, Florence Nightingale Hospital, Demiroglu Bilim University, Istanbul, Turkey.
  • Gulsum Karakas Department of Pulmonary Medicine, Cerrahpasa Medical Faculty, Istanbul Cerrahpasa University, Turkey.

Abstract

A 64-year-old male with a history of stabile chronic obstructive pulmonary disease (COPD) presented with increasing dyspnea and sputum for the last two months. Complete blood count showed WBC 14x103/ml, Hgb: 14.2 g/dL and eosinophilia. Blood biochemistry was normal. Chest x-ray showed hyperlucency while thorax computed tomography (CT) revealed obstructive lung disease and bronchiectasis. Pulmonary function tests demonstrated severe obstructive lung disease and a negative bronchoreversibility with a moderately reduced diffusing capacity/alveolar volume (DLCO/VA). ABG gases revealed significant hypoxemia. Sputum culture was negative. Total IgE was 1140 ng/ml. Aspergillus RAST, precipitins and aspergillusgalactomannan antigen were positive. CF genetic screening tests gave negative results. Allergic bronchopulmonary aspergillosis  (ABPA) is a hypersensitivity reaction that occurs due to bronchial aspergillus colonization. It is most common in patients with asthma and cystic fibrosis. We present a COPD case with an acute exacerbation due to Aspergillus fumigatus that lead to an aberrant clinical profile unresponsive to conventional treatment. Clinicians should consider Aspergillus fumigatus as an etiologic agent in an atypical and severe COPD exacerbation.

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Author Biography

Cuneyt Tetikkurt, Department of Pulmonary Medicine, Cerrahpasa Medical Faculty, Istanbul Cerrahpasa University

Pulmonary Diseases

 

Professor

Published
2020-01-27
Info
Issue
Section
Pneumology - Case Reports
Keywords:
ABPA, COPD, Aspergillus fumigatus, COPD acute exacerbation
Statistics
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  • PDF: 227
How to Cite
Tetikkurt, C., Kubat, B., Tetikkurt, S., & Karakas, G. (2020). An atypical acute exacerbation of COPD due to Aspergillus fumigatus. Monaldi Archives for Chest Disease, 90(1). https://doi.org/10.4081/monaldi.2020.1155

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