Ein Fall von ABPA bei einem Patienten mit Asthma und Bronchiektasien

Allergic bronchopulmonary aspergillosis (ABPA) is a rare pulmonary disease that develops on the background of poorly controlled bronchial asthma, cystic fibrosis, or pre-existing bronchiectasis. Exposure to mold, particularly Aspergillus species, plays a key role in allergic sensitization and the development of chronic infection.We report the case of a patient with allergic bronchopulmonary aspergillosis (ABPA) in the context of bronchial asthma and mold exposure.A 29-year-old man presented to the emergency department with productive cough, hemoptysis, and pleuritic pain in the right hemithorax. Laboratory findings revealed a mildly elevated C-reactive protein (CRP), leukocytosis, and marked eosinophilia, while procalcitonin, liver, and renal parameters were within normal limits. Thoracic CT imaging demonstrated cylindrical bronchiectasis in the right upper lobe with mucoid impaction.Serological testing showed a markedly elevated total IgE level as well as increased Aspergillus-specific IgE and IgG antibodies. Bronchoalveolar lavage (BAL) revealed lymphocytic alveolitis with positive Aspergillus antigen and galactomannan detection, confirming the diagnosis of allergic bronchopulmonary aspergillosis (ABPA).This case illustrates that considering atypical or rare diagnoses beyond standard treatment patterns can be crucial in patients with complex or refractory disease courses.