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Allergic bronchopulmonary aspergillosis

Last reviewed: 15 Apr 2025
Last updated: 16 May 2024

Summary

Definition

History and exam

Key diagnostic factors

  • history of asthma
  • history of cystic fibrosis (CF)
  • teenagers and young adults with CF
  • history of allergic and hypersensitivity disorders
  • cough
  • mucus plugs
  • wheezing
Full details

Other diagnostic factors

  • fever
  • pleuritic chest pain
  • hemoptysis
  • digital clubbing
  • cyanosis
  • weight loss
Full details

Risk factors

  • asthma
  • cystic fibrosis
  • allergic and hypersensitivity disorders
Full details

Diagnostic tests

1st tests to order

  • skin test for Aspergillus fumigatus sensitivity
  • serum total IgE
  • CBC with peripheral blood eosinophil count
  • chest x-ray
  • high-resolution CT chest
  • Aspergillus-specific IgE
Full details

Tests to consider

  • sputum culture and microscopy
Full details

Treatment algorithm

ACUTE

stage 1: acute

stage 2: remission

stage 3: exacerbation

stage 4: corticosteroid-dependent asthma

stage 5: end-stage fibrosis

Contributors

Authors

Carrie Cao, MD

Pulmonary and Critical Care Fellow

Division of Pulmonary and Critical Care Medicine

Stanford University

Stanford

CA

Disclosures

CC declares she does not have any competing interests.

Lauren E Eggert, MD

Clinical Assistant Professor

Division of Pulmonary and Critical Care Medicine

Stanford University

Stanford

CA

Disclosures

LE declares she has served on the advisory boards for AstraZeneca and Regeneron.

Acknowledgements

Dr Carrie Cao and Dr Lauren E Eggert would like to gratefully acknowledge Dr Cristine Radojicic, the previous contributor to this topic.

Disclosures

CR declares she 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.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Patterson TF, Thompson GR 3rd, Denning DW, et al. Practice Guidelines for the Diagnosis and Management of Aspergillosis: 2016 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2016 Aug 15;63(4):e1-e60.Full text  Abstract

Pasteur MC, Bilton D, Hill AT; British Thoracic Society Bronchiectasis non-CF Guideline Group. British Thoracic Society guideline for non-CF bronchiectasis. Thorax. 2010;65(suppl 1):i1-i58.Full text  Abstract

Cystic Fibrosis Foundation. Allergic bronchopulmonary aspergillosis clinical care guidelines. 2003 [internet publication].Full text

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Allergic bronchopulmonary aspergillosis images
  • Differentials

    • Asthma exacerbation
    • Non-ABPA infectious exacerbation of cystic fibrosis
    • Chronic eosinophilic pneumonia
    More Differentials
  • Guidelines

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

    Asthma in adults

    Asthma in children

    More Patient information
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