Reported Two Cases Of Allergic Bronchopulmonary Aspergilosis And Reviewed Literatures

Objective: To investigate the clinical character,diagnosis and treatment of Allergic bronchopulmonary aspergilosis.Methods: A retrospective study was performed which was based on the clinical records of 2 patients with allergic bronchopulmonary aspergilosis in the lst affiliated hospital of Guangxi medieal university from October 2003 to January 2011, and related literatures were reviewed.Results:(1)2 patients without chronic extra-pulmonary disease or immunosuppressive therapy were enrolled, including one man of 47 years old and one women of 42 years old without primary pulmonary disease. The man was office worker,and the woman was peasant.(2)Clinical manifestation: The main clinical manifestations were expectoration of purulent sputum or brown sputum, wheeze relapse, crackles and rhonchal. (3)The main imaging character: the imaging features emerged bronchiectasis, infiltration. Both wider range of lesions involved both sides of the lungs. (4)Laboratory result: 1 patient was the higher number of WBC in peripheral blood and the obviously higher eosinophil ration and percentage before therapy.Lung functions presenced obstructive ventilatory disorder, FEV1, PEF, MMEF75/25 were descend, airway resistance raised,bronchial relaxation test of 1 patient was positive.(5)Pathology and etiology result: Aspergillus were found in the lung tissue, the results of sputum culture was positive in one patients. All results of sputum smear were negative. (6)Misdiagnosis, treatment and tumover: One patient was misdiagnosed as tuberculosis and cough variant asthma,the other was misdiagnosed as pneumonia with poor efficacy of single-use antibiotics, but efficacy of oral or atomization cortisol adding itraconazole or amphotericin. Both were proved in symptom, blood routine test were normol , imaging emerged lesion absorded .Conclusions: (1) allergic bronchopulmonary aspergilosis often be occurred in the patients without primary pulmonary disease,likely misdiagosis as asthma. (2)The typical manifests of Allergic bronchopulmonary aspergilosis included episodic asthma, the aspergillosis hypha seen by microscope in lung tissue or sputum culture, the higher eosinophil, and the main imaging charaeters were bronchiectasis and infiltration. (3) Associating oral or inhale corticosteroid with itraeonazole or amphotericin was effective.