Managing diagnostic complexity: Allergic bronchopulmonary aspergillosis (ABPA) mimicking asthma exacerbation and infections in pediatric cases

Allergic bronchopulmonary aspergillosis (ABPA) presents diagnostic hurdles in pediatrics due to its resemblance to asthma or infections. An 11-year-old girl, known for recurrent asthma-related hospitalizations, presented with ongoing cough and breathing issues. Initial asthma treatment provided temporary relief, but her reliance on oxygen spurred further investigation. Radiological assessments initially suggested infection, confirmed as Klebsiella pneumonia, but antibiotic treatment proved insufficient. Elevated eosinophils, IgE levels, and specific IgE for Aspergillus fumigatus hinted at ABPA. Confirmation led to a successful three-month oral steroid course, combining therapies for effective management. Distinguishing ABPA from asthma and infections demands a thorough approach for timely identification and treatment in pediatric cases.