Invasive pulmonary aspergillosis with no abnormal immunity overlapped with allergic bronchopulmonary aspergillosis - A case report

Sep 30, 2026

Rationale: Invasive pulmonary aspergillosis (IPA) overlapping with allergic bronchopulmonary aspergillosis (ABPA) is an exceptionally rare Aspergillus overlap syndrome with fewer than 30 reported cases since 1936. Patient concerns: A 45-year-old man without underlying disease was admitted with cough, expectoration, fever, and shortness of breath; IPA progressed to ABPA. Diagnoses: IPA overlapping with ABPA. Interventions: Early diagnosis with timely anti-Aspergillus and steroid therapy. Outcomes: Symptoms improved and lesions resolved gradually. Lessons: Alertness to ABPA overlap and early combination treatment can improve prognosis, especially in non-underlying patients.

LanguageEnglish

CategoryHealthcare

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Abstract

Keywords

1. Introduction

2. Case presentation

® Clinical Case Report Invasive pulmonary aspergillosis with no abnormal immunity overlapped with allergic bronchopulmonary aspergillosis A case report Jueqi Lv, MDa , Qian Ning, MDa , Chunxing Que, MDa , Yanbin Wu, MD, PhDa ,* | Abstract
Rationale: Invasive pulmonary aspergillosis (IPA) overlapping with allergic bronchopulmonary aspergillosis (ABPA) is an exceedingly rare disease called Aspergillus overlap syndrome. Fewer than 30 cases have been reported in the literature since 1936. Furthermore, early diagnosis and treatment improve the prognosis of patients, especially those without underlying diseases. Patient concerns: A 45-year-old male patient with no underlying disease who was admitted to the hospital with cough, expectoration, fever, and shortness of breath. The patient was diagnosed with pulmonary aspergillosis overlap syndrome, which progressed from IPA to ABPA.
Diagnoses: IPA overlapping with ABPA.
Interventions: Early diagnosis and timely anti-Aspergillus and steroid treatment.
Outcomes: The patient’s symptoms improved, and the pulmonary lesions gradually resolved.
Lessons: This study emphasizes that patients with IPA without underlying diseases should be alert to ABPA overlap, and early combination therapy can improve prognosis.
Abbreviations: ABPA = allergic bronchopulmonary aspergillosis, ABPM = allergic bronchial mycosis, BALF = bronchoalveolar lavage fluid, CT = computerized tomography, IgE = immunoglobulin E, ISHAM = International Society for Human and Animal Mycology, IPA = invasive pulmonary aspergillosis, mNGS = metagenomic sequencing. | | --- | | Keywords: ABPA, Aspergillus, Aspergillus overlap syndrome, IPA | 1. Introduction Invasive aspergillosis is a severe disease, particularly in immunocompromised individuals, with a high mortality rate. It often occurs in those with conditions like chronic obstructive pulmonary disease, intensive care unit admission, lung cancer, or hematologic malignancy.[1] The spectrum of pulmonary aspergillosis includes allergic bronchopulmonary aspergillosis (ABPA), chronic pulmonary aspergillosis, and invasive pulmonary aspergillosis (IPA), distinguished by immune status and disease risk. [2–4] ABPA usually affects patients with preexisting allergic lung diseases, while IPA is more prevalent in immunocompromised hosts. Although there is evidence that patients with ABPA may develop IPA due to immunosuppression due to JL, QN, and CQ contributed to this article equally. Yanbin Wu is supported by Health Commission of Guangxi Zhuang Autonomous Region Western medicine category self-funded project (Approval No. Z-A20240531) and Guangxi Appropriate Medical Health Technology Promotion Project (Approval No. S2024023). Written informed consent was obtained from the patient herself for publication of this case report and all accompanying images. The authors have no conflicts of interest to disclose. Data sharing not applicable to this article as no datasets were generated or analyzed during the current study. This case report does not involve the disclosure of patients’ personal information or privacy. Ethical approval is not currently considered. a Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, China. long-term glucocorticoid use, progression from IPA or concurrent ABPA in patients without underlying disease has not been well documented. This paper reports a case of IPA overlapping with ABPA. 2. Case presentation A 45-year-old man, a vegetable farmer living in southern China, presented to the emergency department with a history of cough, expectoration, fever for >1 month, and shortness of breath for 13 days. He had a history of smoking and alcohol consumption for over 20 years but no history of allergies or asthma. * Correspondence: Yanbin Wu, Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Guangxi Zhuang Autonomous

FAQs

What condition does the case report describe?

It describes invasive pulmonary aspergillosis (IPA) overlapping with allergic bronchopulmonary aspergillosis (ABPA), termed Aspergillus overlap syndrome.

Who is the patient and what were the initial symptoms?

The patient is a 45-year-old man with no underlying disease, presenting with cough, expectoration, fever for over a month, and shortness of breath for 13 days.

What treatment approach was emphasized in the report?

The report emphasizes early diagnosis and timely anti-Aspergillus therapy together with steroid treatment.

Sep 30, 2026

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