Allergic bronchopulmonary aspergillosis
Allergic bronchopulmonary aspergillosis results from an allergy to Aspergillus spores. In the exam questions often give a history of bronchiectasis and eosinophilia.
Features
Investigations
Management
Features
- bronchoconstriction: wheeze, cough, dyspnoea
- bronchiectasis (proximal)
Investigations
- eosinophilia
- flitting CXR changes
- positive radioallergosorbent (RAST) test to Aspergillus
- positive IgG precipitins (not as positive as in aspergilloma)
- raised IgE
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| © Image used on license from Radiopaedia | |
Chest x-ray of a 40-year-old woman with ABPA demonstrating a mass overlying the left hilum. In the right upper parahilar region a few ring shadow / tram track opacities are also noted, suggestive of bronchiectasis
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| © Image used on license from Radiopaedia | |
CT scan from the same patient. CT reveals a branching lesion in the superior segment of the left lower lobe with classic finger in glove appearance which represents of mucous filling dilated bronchi (i.e. bronchocoeles). Bronchocoeles are a common feature of allergic bronchopulmonary aspergillosis (ABPA)
Management
- steroids
- itraconazole is sometimes introduced as a second line agent