Definition

• Allergic bronchopulmonary aspergillosis (ABPA): a hypersensitivity reaction caused by exposure to Aspergillus that mostly occurs in patients with cystic fibrosis or asthma
• Chronic pulmonary aspergillosis: a long-term Aspergillus infection of the lung which can manifest as:
  • Aspergilloma: an opportunistic infection of a pre-existing cavitary lesion (e.g. from previous tuberculosis)
  • Chronic necrotizing pulmonary aspergillosis: a subacute and semi-invasive form of chronic pulmonary aspergillosis characterized by localized, slowly progressive, inflammatory destruction of lung tissue and commonly associated with alcohol use disorder
• Invasive aspergillosis: a severe form of Aspergillus infection which manifests with severe pneumonia and septicemia with potential involvement of other organs (e.g., skin, CNS) and mostly occurs in immunocompromised individuals

Etiology

Pathophysiology

Clinical features

Allergic bronchopulmonary aspergillosis

• Persistent asthma symptoms and acute asthma exacerbations
• Productive cough with brown mucus plugs, hemoptysis
• Low-grade fever, fatigue, malaise, weight loss
• Clinical features of sinusitis in patients with concurrent allergic fungal rhinosinusitis

Diagnostics

ABPA

• ↑ Total IgE levels
• Eosinophilia
• Central bronchiectasis

Treatment