Allergic Bronchopulmonary Aspergillosis

Allergic bronchopulmonary aspergillosis (ABPA) is an allergic reaction to the ubiquitous fungus aspergillus. The allergic reaction causes inflammation of the airways and lungs in susceptible people, usually only in those with chronic asthma or cystic fibrosis. In fact, ABPA may mimic asthma and pneumonia, sometimes making treatment of asthma more complicated. Symptoms of ABPA may include worsening of asthma, wheezing, cough, cough associated with brownish or reddish sputum, and fever. If ABPA is suspected, diagnostic tests include CBC, IgE and aspergillus antibodies, aspergillus antigen skin testing, imaging of the chest by xray or CT, and possibly bronchoscopy and/or biopsy. If these tests are positive, treatment is with prednisone, sometimes with an antifungal medicine such as itraconazole added. Although aspergillus is found widely in the environment, it is particularly common in places where there is dead and decaying vegetation and in areas with bird droppings; these places should be avoided in children with asthma, particularly those with a diagnosis of ABPA. [Zieve: 2010]