Bronchiectasis and Allergic Bronchopulmonary Aspergillosis
The chapter delves into the diagnostic features of bronchiectasis on CT scans, outlining key radiographic findings and distribution patterns in different lung lobes. It also explores the case of a patient with worsening episodic dyspnea, discussing the differential diagnosis, diagnostic workup, and the eventual diagnosis of allergic bronchopulmonary aspergillosis (ABPA). The treatment approach for ABPA, including a combination of steroids and antifungals, is detailed alongside monitoring strategies and emerging therapy options for steroid-dependent cases.
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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.
