A Rare Case of Allergic Bronchopulmonary Aspergillosis Progressing to Cardiac Tamponade in the Al Qassim Region of Saudi Arabia

Allergic bronchopulmonary aspergillosis (ABPA) is a condition characterized by an exaggerated response of the immune system (a hypersensitivity response) to the fungus Aspergillus. Aspergillus-associated pericarditis leading to pericardial tamponade is rare. In our case, we presented a case of a 22-year-old female asthmatic patient with no other medical conditions who presented to the emergency department (ED) complaining of severe chest tightness and shortness of breath. Echocardiography revealed significant pleural and pericardial effusion consistent with cardiac tamponade. Both pleural and pericardial fluids were hemorrhagic. Four months later, she presented to the ED with chief complaints of shortness of breath and a cough lasting two days. She was admitted as a case of asthma exacerbation. In the following months, when the patient visited the pulmonology outpatient clinic, the doctors recommended for specific IgE test. Allergen-specific IgE testing was positive for A. fumigatus to confirm the presence of ABPA. As we rolled out other causes of cardiac tamponade, we link the development of cardiac tamponade secondary to an underlying Aspergillus infection. We report this case with the aim of improving clinical knowledge regarding probable causes of cardiac tamponade in patients with asthma, which may facilitate the establishment of early diagnosis and treatment protocols.