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Allergic Bronchopulmonary Aspergillosis: Causes, Symptoms, Diagnosis, Treatment, Complications And Prognosis

Jul 25, 2023

Allergic Bronchopulmonary Aspergillosis

Aspergillus fumigatus is a fungus that can cause allergic bronchopulmonary aspergillosis (ABPA), which is an allergic or hypersensitive reaction. This fungus can be discovered in the dirt.

A reaction to Aspergillus is uncommon in persons with healthy immune systems, despite the fact that the majority of us are routinely exposed to it. However, in some individuals, the immune system overreacts to the Aspergillus fumigatus antigens present in the lungs. 

As a result, there could be long-term lung damage and airway injury. People with cystic fibrosis or asthma are most frequently impacted by ABPA.

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Causes Of  Allergic Bronchopulmonary Aspergillosis 

It is caused by a fungus called Aspergillus fumigates. In addition to soil, water, and dust, it can also be found in other areas. The inhalation of this fungus results in ABPA. The lungs repeatedly get inflamed as a result of the chronic response it generates.

Approximately 2 to 11% of persons with cystic fibrosis get infected with ABPA, according to the Cystic Fibrosis Foundation. Teenagers and guys are more likely to experience it.

Symptoms of Allergic Bronchopulmonary Aspergillosis 

The signs of ABPA aspergillosis might not be immediately apparent. People frequently become aware of an increase in their asthma symptoms first. Some people may also be feverish.

The following symptoms of allergic bronchopulmonary aspergillosis:

  • Wheezing
  • Cough
  • Breathing difficulty
  • Stiffness or pain in the chest
  • Cough with brownish flecks or plugs or bloody mucus
  • A potentially reversible fever
  • General weakness, malaise, or exhaustion

Diagnosis of Allergic Bronchopulmonary Aspergillosis 

Several tests may be recommended if your doctor thinks you might have ABPA. The symptoms, along with the findings from those tests, are used to make the diagnosis. Some tests might be:

  • IgE levels in blood tests to check for allergy symptoms
  • A CT scan that provided a thorough view of the lungs
  • A blood or skin test for aspergillus-specific IgE levels.
  • Pneumonia sample
  • According to the American Thoracic Society, chest X-rays can be performed but are frequently ineffective in identifying ABPA.
  • To assess the severity of your lung condition and gauge how well you are handling treatment, lung function testing (also known as spirometry) may be utilized.

Treatment of Allergic Bronchopulmonary Aspergillosis 

Since it is difficult to prevent the fungus that produces a response, medication is frequently suggested to treat ABPA.

Oral corticosteroids, a common asthma medicine, help to expand the airways, which facilitates coughing up the fungus. The individual and the degree of ABPA rely on the use of this medicine. When symptoms arise, some patients are advised to take their medication. Others who have the condition more severely could need daily corticosteroid medication.

There may also be a recommendation for an oral antifungal such as itraconazole, despite considerable debate over its efficacy.

In order to avoid or reduce harm to your lungs, your doctor should regularly monitor you if you are diagnosed with ABPA.

Complications Of Allergic Bronchopulmonary Aspergillosis 

Untreated allergic bronchopulmonary aspergillosis can lead to a number of complications, such as:

  • Hemoptysis causes blood-tinged phlegm to be coughed up as well as bleeding from inflamed and irritated airways.
  • Repeated episodes of inflammation that cause bronchiectasis gradually weaken the bronchiolar walls.
  • Atelectasis is a collapse of the lung tissue to varied degrees.
  • Airways become clogged or are compressed shut by a severe asthma episode, resulting in respiratory failure. A medical emergency has occurred.

Prognosis Of Allergic Bronchopulmonary Aspergillosis 

Although itraconazole and prednisone are commonly successful in improving the symptoms for years, there is currently no known cure for ABPA. However, care of the inflammation and scarring can help prolong life.

In non-immunocompromised patients, ABPA can proceed to chronic pulmonary aspergillosis.

It takes time for the long-term effects of care improvements to be felt because this sickness is still considered to be "young" and has a long incubation period. Since additional severe asthmas have been found to contain a fungal component, it is possible that ABPA is considerably more widespread than previously believed.

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