A case report of pulmonary thromboembolism following allergic bronchopulmonary aspergillosis

Medicine (Baltimore). 2020 Jan;99(2):e18692. doi: 10.1097/MD.0000000000018692.

Abstract

Rationale: Allergic bronchopulmonary aspergillosis (ABPA) complicated with pulmonary thromboembolism (PTE) is rare. This report describes a patient who was diagnosed with ABPA and soon developed PTE.

Patient concerns: A 64-year-old man was diagnosed with ABPA in hospital for recurrent fever with cough. Two months later, the patient was readmitted to the hospital because of PTE.

Diagnoses: ABPA was diagnosed during the first hospitalization, and laboratory tests showed an increase in serum IgE and Aspergillus fumigatus-specific IgG. Sputum culture suggested A. fumigatus and high-resolution computed tomography (HRCT) showed inflammation of both lungs and central bronchiectasis. During the second hospitalization, the patient's chest angiography showed PTE.

Interventions: The patient began treatment with antifungal drugs and corticosteroids, and was discharged from the hospital when his condition improved. Two months after discharge, the patient was treated with anticoagulant drugs due to PTE.

Outcomes: The patient got better after taking anticoagulant drugs and was discharged from the hospital. The patient appears for regular follow-up visits in our outpatient clinic every 2 months and is currently in good condition.

Lessons: Patients with ABPA may be concurred with PTE. The risk of PTE in ABPA should be assessed in advance and preventive strategies also need to be taken beforehand. Pulmonary artery examination is necessary once it happened.

Publication types

  • Case Reports

MeSH terms

  • Anticoagulants / therapeutic use
  • Antifungal Agents / therapeutic use
  • Aspergillosis, Allergic Bronchopulmonary / complications*
  • Aspergillosis, Allergic Bronchopulmonary / drug therapy
  • Humans
  • Male
  • Middle Aged
  • Pulmonary Embolism / drug therapy
  • Pulmonary Embolism / etiology*

Substances

  • Anticoagulants
  • Antifungal Agents