Pleural effusion. An unfamiliar presentation of ABPA

Pleural effusion is rarely encountered in patients of allergic bronchopulmonary aspergillosis (ABPA). We report the case of a 17-year-old male who presented with complaints of fever, cough and increasing shortness of breath for 3 weeks. Patient had breathlessness with seasonal variation. Patient had right lower lobe consolidation with pleural effusion which did not respond to antibiotics. Pleural fluid was exudate with neutrophilic predominance and low ADA. Skin prick test for Aspergillus fumigatus was positive, both total IgE and specific IgE against Aspergillus fumigatus were raised.