A report of a successfully treated case of ABPA in an HIV-infected individual

BMJ Case Rep. 2014 Nov 9:2014:bcr2014206236. doi: 10.1136/bcr-2014-206236.

Abstract

Aspergillus fumigatus is a ubiquitous fungus responsible for a variety of pulmonary diseases, ranging from infection of a pre-existing cavity as in aspergilloma to highly invasive disease in immunocompromised hosts. Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity response mounted against antigens of A. fumigatus manifesting as poorly controlled asthma and bronchiectasis. Although ABPA is not uncommon, occurrence of ABPA in HIV-affected individuals is distinctly rare. We describe the occurrence of ABPA in a 35-year-old woman with poorly controlled asthma since childhood and HIV-1 infection of 11 years duration. This is the second documented case of ABPA in a HIV-affected individual, and the first reported case to be successfully managed with antifungal therapy alone. We also discuss the complex management issues involved in treating ABPA in HIV-affected individuals.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antibodies / blood
  • Antifungal Agents / therapeutic use*
  • Aspergillosis, Allergic Bronchopulmonary / diagnosis
  • Aspergillosis, Allergic Bronchopulmonary / drug therapy*
  • Aspergillus fumigatus / immunology
  • Female
  • HIV Infections / complications*
  • Humans
  • Immunoglobulin E / immunology
  • Itraconazole / therapeutic use*

Substances

  • Antibodies
  • Antifungal Agents
  • Itraconazole
  • Immunoglobulin E