Allergic bronchopulmonary aspergillosis

Last reviewed: 23 Aug 2023
Last updated: 26 Nov 2020



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
  • hemoptysis
  • 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
  • CBC 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


stage 1: acute

stage 2: remission

stage 3: exacerbation

stage 4: corticosteroid-dependent asthma

stage 5: end-stage fibrosis



Cristine Radojicic, MD

Staff Physician

Department of Pulmonary, Allergy and Critical Care

Cleveland Clinic




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

Peer reviewers

Martin Schöni, MD


Department of Pediatrics

University of Bern




MS declares that he has no competing interests.

Jordan Fink, MD

Professor of Pediatrics

Allergy-Immunology Division

Medical College of Wisconsin




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

  • Allergic bronchopulmonary aspergillosis images
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  • Guidelines

    • Practice guidelines for the diagnosis and management of aspergillosis
    • Allergic bronchopulmonary aspergillosis clinical care guidelines
    More Guidelines
  • Patient leaflets

    Asthma in adults

    Asthma in children

    More Patient leaflets
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