Cystic fibrosis complicated by allergic bronchopulmonary aspergillosis

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Diagnosis certain
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Presentation

Pediatric patient with known cystic fibrosis presents with worsening cough. On examination, there was reduced air entry in the right upper lobe.

Patient Data

Age: 8 years
Gender: Male
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Info

There is nodular dense opacification in a finger-in-glove configuration overlying the right hilum and extending into the right upper lobe. This is likely to represent a combination of hilar lymphadenopathy and infective consolidation/bronchial plugging. In addition, there is perihilar consolidation on the left.

Case Discussion

Atopic patients are predisposed to allergic bronchopulmonary aspergillosis (ABPA) through defective immuno-regulation. Both asthma and cystic fibrosis are strongly associated with atopy. Presenting symptoms raising the possibility of ABPA in these patient groups include worsening respiratory symptoms, low-grade fever, weight loss and malaise.  

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