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Abstract
Allergic Bronchopulmonary Aspergillosis (ABPA) is a complex condition that often presents challenges in diagnosis in patients with a history of asthma. We present a young female with a one-month history of cough and shortness of breath, initially suspected to be an asthma exacerbation. Despite treatment with low-dose corticosteroids and antibiotics, her symptoms persisted, prompting further investigation. Sputum cultures were negative, and a GeneXpert test ruled out Mycobacterium tuberculosis. Lung function tests indicated reduced airflow, while a computed tomography scan revealed hyperattenuating areas in the right middle lobe and anterior left upper lobe, dilated bronchi, and a thick-walled cavity in the right lower lobe. The diagnosis of ABPA was complicated by overlapping symptoms with asthma, the absence of definitive serological markers, and the potential impact of previous treatments on inflammatory responses. This case illustrates the need for a comprehensive evaluation and highlights the importance of recognizing the diagnostic criteria for ABPA. A multidisciplinary approach is essential for timely and accurate diagnosis of ABPA in patients with asthma, ensuring appropriate management and improved patient outcomes