Health Encyclopedia

Pulmonary aspergillosis - allergic bronchopulmonary type

Definition

Pulmonary aspergillosis is an allergic reaction to a fungus called aspergillus, which causes inflammation of the airways and air sacs of the lungs.

Alternative Names

Aspergillosis - allergic bronchopulmonary; Allergic bronchopulmonary aspergillosis; ABPA

Causes, incidence, and risk factors

The aspergillus fungus is common. It can grow on dead leaves, stored grain, bird droppings, compost stacks, and other decaying vegetation.

Although most people are frequently exposed to aspergillus, infections caused by it are rare in people with a normal immune system. These rare infections include pneumonia and fungus ball (aspergilloma).

Some people, however, have an allergic reaction (hypersensitivity) to this fungus, which is called allergic bronchopulmonary aspergillosis (ABPA). It is characterized by inflammation of the airways (bronchi) or air sacs (alveoli). The disease may mimic asthma or pneumonia, and, in fact, most patients with ABPA have asthma as well.

Patients with asthma or cystic fibrosis are at highest risk for allergic aspergillosis.

Symptoms

Cough may produce brownish plugs or bloody sputum
Fever
Generalized weakness
Wheezing
Worsening symptoms of asthma

Signs and tests

Aspergillus antigen skin test
Bronchoscopy and transbronchial biopsy
CBC with peripheral eosinophil (a type of white blood cell) count
Chest x-ray
CT scan - chest
Lung biopsy (rare)
Serum aspergillus antibodies
Serum IgG and IgE antibodies
Sputum stain and culture for fungus

Treatment

Allergic aspergillosis is treated with steroids such as prednisone. The antifungal antibiotic itraconazole can also be helpful. People with asthma should also continue their usual treatments.

Expectations (prognosis)

People usually get better with treatment, over time. Relapses requiring repeat treatment are common.

Complications

Bronchiectasis (permanent scarring of the small sacs in the lungs)
Mucous plugs
Permanent airway obstruction
Respiratory failure

Calling your health care provider

Call your health care provider if you have symptoms of this disorder.

Call your health care provider if breathing becomes more difficult. Severe breathing difficulty is an emergency.

Prevention

People at higher risk (those with asthma, cystic fibrosis, etc.) should try to avoid environments where this fungus is found.

References

Walsh TJ, Anaissie EJ, Denning DW, et al. Treatment of aspergillosis: clincial practice guidelines of the Infectious Diseases Society of America. Clin Infect Dis. 2008;46(3):327-360.

Review Date:5/19/2008
Reviewed By:Sean O. Stitham, MD, private practice in Internal Medicine, Seattle, WA; Jatin M. Vyas, MD, PhD, Instructor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Massachusetts General Hospital.. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997-A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

The Agency for Health Care Administration (Agency) and this website do not claim the information on, or referred to by, this site is error free. This site may include links to websites of other government agencies or private groups. Our Agency and this website do not control such sites and are not responsible for their content. Reference to or links to any other group, product, service, or information does not mean our Agency or this website approves of that group, product, service, or information.

Additionally, while health information provided through this website may be a valuable resource for the public, it is not designed to offer medical advice. Talk with your doctor about medical care questions you may have.