MK is 59 years old and presented with right sided pleuritic chest pain and coughing over 1 week. A chest Xray and then CT scan revealed complete collapse of her right lower lobe and middle lobes. Mucous retention is seen just proximal to the abrupt cutoff. There was mild bronchiectasis.
A bronchoscopy found large amounts of mucous that was suctioned and removed. Aspergillus was found in the mucous on microscopy and A. fumigatus grown in culture.
She felt better immediately and a follow up scan shows re-expansion of the right middle and lower lobes.
A diagnosis of Aspergillus bronchitis was made based on the bronchoscopy findings, microscopy and culture results and supported by an positive Aspergillus IgG of 97mg/L (ImmunoCap).