Don't forget other causes of wheeze. ABPA in a boy with asthma. A case report and review of the literature.

UNLABELLED: Allergic bronchopulmonary aspergillosis (ABPA) is a rare pulmonary disorder caused by hypersensitivity to Aspergillus fumigatus. The prevalence is estimated to be about 1-2% in adult patients with asthma and 2-15% in patients with cystic fibrosis. In paediatric patients with asthma, only single case reports on ABPA exist. We report on a 13-year-old boy with allergic asthma complicated by ABPA. Despite the presentation of typical clinical symptoms, it took 6 years before he was diagnosed. The clinical course improved rapidly after ABPA therapy was started, and 12 months after diagnosis, the boy is still free of symptoms. Clinical symptoms of ABPA may be unspecific making a rapid diagnosis difficult in some cases.

CONCLUSION: A delay in diagnosis and treatment increases the risk for irreversible lung damage. Once bronchiectasis has developed, the outcome is unfavourable. Thus, ABPA has to be considered in patients whose asthma remains uncontrolled despite adequate therapy.