Allergic bronchopulmonary aspergillosis presenting with cough variant asthma with spontaneous remission

A 60-year-old woman presented with a dry cough without dyspnea or wheezing. Chest CT showed an image of mucoid impactions, which were identified as mucoid impactions by bronchofiberscopy. Aspergillus niger was cultured from her mucus. Her serum total IgE was 5150 IU/ml. Precipitins and IgE specific for Aspergillus were positive. She had no history of asthma and no evidence of bronchoconstriction by pulmonary function tests. Thus, a diagnosis was made of allergic bronchopulmonary aspergillosis without asthma. She refused to take oral corticosteroids, although she improved spontaneously. However, her dry cough persisted. Her cough was relieved by administering an inhaled β-2 agonist; therefore, cough variant asthma was diagnosed. She was treated with an inhaled corticosteroid and her cough resolved completely.