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Lung India Official publication of Indian Chest Society  
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Year : 2020  |  Volume : 37  |  Issue : 2  |  Page : 161-163

Successful treatment of allergic bronchopulmonary aspergillosis with posaconazole in a child with cystic fibrosis: Case report and review of the literature

1 Department of Pediatrics, Division of Pediatric Infectious Diseases, Marmara University School of Medicine, Istanbul, Turkey
2 Department of Pediatrics, Division of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey

Correspondence Address:
Dr. Nurhayat Yakut
Fevzi Cakmak Mahallesi Muhsin Yazicioğlu Cad. No: 41, Ustkaynarca, Pendik, Istanbul, Turkey
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/lungindia.lungindia_288_19

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Allergic bronchopulmonary aspergillosis (ABPA) is recognized as a rare, progressive, allergic disorder in patients with cystic fibrosis (CF) and asthma. Treatment of ABPA mainly includes systemic corticosteroids (CSs) and antifungal agents. Here, we report posaconazole treatment in a 9-year-old male child with ABPA and also review the literature on antifungal management of ABPA. The child with CF was admitted to the emergency room with complaints of fever, productive cough, and acute dyspnea. Auscultation of the lungs revealed obvious bilateral fine crackles and bilateral rhonchus. He was started with intravenous meropenem and amikacin for acute exacerbation. The patient was diagnosed with ABPA because of his failure to respond to antibiotherapy, elevated serum immunoglobulin (Ig) E, specific IgE, to Aspergillus fumigatus levels and sputum growth of A. fumigatus. He was successfully treated with posaconazole with marked clinical and laboratory improvement and no adverse effects. CSs and antifungal agents are the mainstay of therapy in patients with ABPA based on observational studies in children. Posaconazole is a useful treatment option for patients with ABPA.

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