Allergic Bronchopulmonary Aspergillosis

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• Aspergillus fumigatus is a ubiquitous fungus which may colonise the respiratory tract as an incidental finding without giving rise to symptoms

• Can cause an aspergilloma

Invasive aspergillosis 

• Patients with Asthma may develop an allergic reaction (Type I and III hypersensitivity) to the fungus and demonstrate precipitating Ab, in serum and +ve skin prick tests

• Some develop ABPA:

• Initially bronchoconstriction, but as inflammation persists, permanent damage occurs, causing bronchiectasis (due to thick mucus plugs causing obstruction of small bronchi)

• RX = suppression of immune system by oral prednisolone and high-dose inhaled steroids