A Case of Worsening Episodic Dyspnea Diagnosis and Management
This chapter delves into a case of a woman with well-managed asthma experiencing exacerbations, eventually diagnosed with Allergic Bronchopulmonary Aspergillosis (ABPA). It discusses the challenges faced during initial treatment and the subsequent improvement observed with monoclonal antibody therapy, emphasizing the significance of tailored management and interpreting diagnostic tests effectively.
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Transcript
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Transcript
Episode notes
The Pulm PEEPs are excited to bring our first mystery case! Kristina Montemayor and Dave Furfaro hear a fascinating case presentation from Pulm PEEPs senior editor Ansa Razzaq. Join us as we work through this case together to come to a diagnosis, and share our thought process along the way. Come back to these show notes afterward, or once you’ve solved the case yourself, for some key teaching pearls and representative images.
Patient Presentation
A 66-year-old woman with no smoking history and past medical history of previously well-controlled asthma is referred to pulmonary clinic after multiple recent episodes of dyspnea, wheezing, and coughing. The episodes have features consistent with asthma exacerbations; however, they are also associated with migratory infiltrates. She has been treated with multiple courses of antibiotics and steroids, and despite escalating therapy, the episodes are occurring more frequently and she was worsening overall exercise tolerance. Listen in to hear more and try to solve the case!
Representative Imaging
Key Learning Points
**Spoilers Ahead** If you want to think through the case on your own we advise listening to the episode first before looking at the infographics below.
