Allergic bronchopulmonary aspergillosis (ABPA) is an allergic lung disorder. It is related to a fungus. Aspergillosis can also occur as: A lung infection that can spread to other parts of the body, which is more common in patients with suppressed immune systemsA fungal growth in a lung cavity that has healed from a previous lung disease or infection
ABPA is caused by an allergic reaction to an inhaled fungus. It grows and flourishes in decaying vegetation, soil, certain foods, dust, and water. The inhaled fungus colonizes mucus in the lungs, causing: Sensitization to the fungusRecurring allergic inflammation of the lungsPacking of the tiny alveoli air sacs in the lungs with a type of white blood cell involved in certain allergic reactions and infections with parasites
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Symptoms of ABPA are usually those of progressive asthma. These include: Shortness of breathCoughWheezingWeaknessChest pain
As ABPA progresses, other symptoms may occur, including: Production of thick, brownish, and/or bloody sputumMild feverUnintended weight loss
You will be asked about your symptoms and medical history. A physical exam will be done.
Images may be taken of your bodily structures. This can be done with: Chest x-rayCT
Your bodily fluids and tissues may be tested. This can be done with: Sputum testsBlood testsSkin prick testsBiopsy of lung
or sinus tissue
Your lungs may be tested. This can be done with
pulmonary function tests (PFTs)
ABPA can appear quite similar to non-ABPA induced asthma. ABPA is typically diagnosed after several repeat tests for ABPA are positive over a number of months or years.
The goals of treatment include: Suppressing the allergic reaction to the fungusMinimizing lung inflammationPreventing the fungus from colonizing the lungs
ABPA is usually treated with: Steroids—may be taken by mouth or inhaled depending on the severity of the symptomsAntifungal drugsMedications used for asthma, such as bronchodilators or other anti-allergy medication
Avoiding exposure to fungus is the best way to prevent ABPA. However, this is difficult, because fungus is so prevalent in the environment. Guidelines to help prevent exposure to the fungus include:
Avoiding areas with:
Decaying vegetationStanding waterKeeping your home as dust-free as possibleRemaining in air-filtered, air-conditioned environments whenever possible
Measures to avoid symptoms and prevent permanent lung damage caused by ABPA include: Ongoing testing and monitoring of ABPAEarly and continuing medical treatment for the disease
Allergic bronchopulmonary aspergillosis (ABPA). American Academy of Allergy Asthma & Immunology website. Available at:
http://www.aaaai.org/conditions-and-treatments/related-conditions/allergic-bronchopulmonary-aspergillosis.aspx.Accessed November 13, 2015.
Wark PA, Gibson PG, Wilson AJ. Azoles for allergic bronchopulmonary aspergillosis associated with asthma. Cochrane Database Syst Rev 2004; (3): CD001108.
Last reviewed November 2015 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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