An atypical acute exacerbation of COPD due to Aspergillus fumigatus

Submitted: August 17, 2019
Accepted: December 15, 2019
Published: January 27, 2020
Abstract Views: 1421
PDF: 1028
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A 64-year-old male with a history of stabile chronic obstructive pulmonary disease (COPD) presented with increasing dyspnea and sputum for the last two months. Complete blood count showed WBC 14x103/ml, Hgb: 14.2 g/dL and eosinophilia. Blood biochemistry was normal. Chest x-ray showed hyperlucency while thorax computed tomography (CT) revealed obstructive lung disease and bronchiectasis. Pulmonary function tests demonstrated severe obstructive lung disease and a negative bronchoreversibility with a moderately reduced diffusing capacity/alveolar volume (DLCO/VA). ABG gases revealed significant hypoxemia. Sputum culture was negative. Total IgE was 1140 ng/ml. Aspergillus RAST, precipitins and aspergillusgalactomannan antigen were positive. CF genetic screening tests gave negative results. Allergic bronchopulmonary aspergillosis  (ABPA) is a hypersensitivity reaction that occurs due to bronchial aspergillus colonization. It is most common in patients with asthma and cystic fibrosis. We present a COPD case with an acute exacerbation due to Aspergillus fumigatus that lead to an aberrant clinical profile unresponsive to conventional treatment. Clinicians should consider Aspergillus fumigatus as an etiologic agent in an atypical and severe COPD exacerbation.



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Cuneyt Tetikkurt, Department of Pulmonary Medicine, Cerrahpasa Medical Faculty, Istanbul Cerrahpasa University

Pulmonary Diseases



How to Cite

Tetikkurt, Cuneyt, Bahar Kubat, Seza Tetikkurt, and Gulsum Karakas. 2020. “An Atypical Acute Exacerbation of COPD Due to Aspergillus Fumigatus”. Monaldi Archives for Chest Disease 90 (1).