Allergic bronchopulmonary aspergillosis

Last reviewed: 17 Apr 2022
Last updated: 26 Nov 2020

Summary

Definition

History and exam

Key diagnostic factors

  • history of asthma
  • history of cystic fibrosis (CF)
  • teenagers and young adults with CF
  • history of atopy
  • cough
  • mucus plugs
  • wheezing
More key diagnostic factors

Other diagnostic factors

  • fever
  • pleuritic chest pain
  • haemoptysis
  • finger clubbing
  • cyanosis
  • weight loss
Other diagnostic factors

Risk factors

  • asthma
  • cystic fibrosis
  • atopy
  • HLA-DR2- and HLA-DR5-positive
  • IL-10 promoter polymorphisms
  • surfactant protein polymorphisms
  • CFTR gene
More risk factors

Diagnostic investigations

1st investigations to order

  • skin test for Aspergillus fumigatus sensitivity
  • serum total IgE
  • FBC with peripheral blood eosinophil count
  • chest x-ray
  • CT chest
  • Aspergillus-specific IgE
More 1st investigations to order

Investigations to consider

  • Aspergillus-specific IgG
  • serum precipitating antibodies to Aspergillus fumigatus
  • sputum culture and microscopy
  • HLA antigens
More investigations to consider

Treatment algorithm

ACUTE

stage 1: acute

stage 2: remission

stage 3: exacerbation

stage 4: corticosteroid-dependent asthma

stage 5: end-stage fibrosis

Contributors

Authors

Cristine Radojicic, MD

Staff Physician

Department of Pulmonary, Allergy and Critical Care

Cleveland Clinic

Cleveland

OH

Disclosures

CR is on the Advisory Board for CSL Behring and the Speakers Bureau for BioCryst.

Peer reviewers

Martin Schöni, MD

Professor

Department of Pediatrics

University of Bern

Bern

Switzerland

Disclosures

MS declares that he has no competing interests.

Jordan Fink, MD

Professor of Pediatrics

Allergy-Immunology Division

Medical College of Wisconsin

Milwaukee

WI

Disclosures

JF is an author of a number of references cited in this topic.

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  • Differentials

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    • Non-ABPA infectious exacerbation of cystic fibrosis
    • Chronic eosinophilic pneumonia (CEP)
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  • Guidelines

    • ABPA and aspergillus lung infection, cystic fibrosis patients
    • Practice guidelines for the diagnosis and management of aspergillosis
    More Guidelines
  • Patient leaflets

    Bronchiectasis: what is it?

    Bronchiectasis: what treatments work?

    More Patient leaflets
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