[Allergic bronchopulmonary aspergillosis in a patient with diabetes mellitus as the only risk factor].

Rev Alerg Mex

Servicio de Neumología y Cirugía de Tórax; Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México (UNAM), Tlalnepantla, Estado de México.

Published: September 2024

AI Article Synopsis

  • Allergic bronchopulmonary aspergillosis is a rare immune response to the fungus Aspergillus fumigatus, leading to symptoms like lung inflammation and high eosinophil counts in the blood.
  • A 42-year-old male with diabetes exhibited severe respiratory issues and was found to have high eosinophils and elevated IgE for the fungus; he was treated with oxygen, prednisone, and itraconazole, resulting in improvement.
  • The condition can be deadly, especially in immunocompromised individuals; diabetic patients have a higher prevalence of fungal infections, with nearly 37% potentially affected compared to only 4.7% in non-diabetics.

Article Abstract

Background: Allergic bronchopulmonary aspergillosis is a rare entity, caused by a hypersensitivity reaction of the immune system to Aspergillus fumigatus, characterized by the presence of pulmonary infiltrates, bronchiectasis and increased eosinophils in peripheral blood.

Case Report: 42-year-old male with diabetes mellitus, with poor adherence to treatment, went to the emergency room due to rapidly progressive dyspnea and severe hypoxemia, pneumonia and bilateral pleural effusion were evident, laboratory studies reported, HbA1c 9.4%, eosinophils 3650 cells/mL, serum IgE for Aspergillus fumigatus 0.84 IU/mL. Treatment was started with supplemental oxygen, prednisone and itraconazole, to which the patient showed clinical and radiological improvement.

Conclusions: Invasive mycoses have a mortality of 21 to 80%, frequently in immunocompromised patients, they are usually not described in patients with diabetes mellitus; The prevalence of fungal colonization among diabetic patients has been described as 37% compared to 4.7% in non-diabetic patients.

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Source
http://dx.doi.org/10.29262/ram.v71i3.1383DOI Listing

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