Date: 26 November 2013
The patient underwent a pneumonectomy because of the severity of her disease process, and uncertainty about the diagnosis, prior to serology results being obtained.
Serology showed an IgE of 2600, with a strongly positive Aspergillus RAST test and weakly positive Aspergillus precipitins. Material removed at bronchoscopy showed eosinophilia. These features confirm a diagnosis of allergic bronchopulmonary aspergillosis (ABPA).
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© Fungal Infection Trust
Notes:
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4 Total obstruction of the sinuses due to inflamed mucosa. (Patient 04)
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1 Axial computed tomography (CT) scans of the frontal sinus.
A: due to the long lasting pressure of mucus, the bone of the anterior wall of frontal sinus is thinned out and elevated anteriorly, forming a bulge. B: same situation as depicted in fig A: the posterior bony wall of frontal sinus is thinned out and extremely elevated posteriorly towards the frontal lobe of the brain. As depicted on the scan, a thin bony layer covering the dura could be recognized intraoperatively -
2 Same patient as 1 and 3, frontal CT
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D. 6 months later, tenacious yellow secretions in L basal bronchial division
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C. After suction the material was seen to extend distally – obstructing the right basal stem bronchus
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B. After suction the material was seen to extend distally – obstructing the right basal stem bronchus