Allergic Bronchopulmonary Aspergillosis Flashcards
What is Allergic bronchopulmonary aspergillosis?
Hypersensitivity rection to bronchial colonisation by Aspergillus (most commonly aspergillus fumigatus)
What usually features in the history of a patient presenting with Allergic bronchopulmonary aspergillosis?
Atopy
Bronchiectasis: asthma, CF
Eosinophilia
Give 3 symptoms of Allergic bronchopulmonary aspergillosis
Wheeze
Cough
Dyspnoea
What are the 5 major features of ABPA?
- Hx of asthma
- Radiographic features of central bronchiectasis/ pulmonary opacities
- Blood eosinophilia
- Immediate skin reactivity to aspergillus antigen
- Increased serum IgE >1000
What investigations should be performed for ABPA?
Skin prick testing
Bloods: FBC with eosinophil count, IgE
CXR
Describe the management of ABPA
Oral glucocorticoids
(Itraconazole 2nd line)
What is the spectrum of infection with aspergullus?
Colonisation
Allergy: ABPA
Asthma
Chronic pulmonary aspergillosis + Aspergilloma (fungal ball)
Invasive aspergillosis
Describe formation of aspergillomas
Occur in pre-existing lung cavities
Commonly secondary to TB
What is chronic pulmonary aspergillosis?
Chronic infection with aspergillus
Occurs in those with pre-existing structural lung disease
What is invasive pulmonary aspergilosis? List 5 symptoms
Life-threatening infection in immunocompromised
Fever
Pleuritic chest pain
Haemoptysis
Cough
Dyspnoea
What is the treatment for invasive aspergillosis?
Suspected: Amphotericin B IV
Confirmed: Isavuconazole IV
Describe management of aspergilloma with life-threatening haemoptysis
Stabilisation with IV fluids + blood transfusion
Surgical resection
Describe management of asymptomatic aspergilloma
No intervention
Annual imaging
