ABPA
- patients: underlying asthma, CF
- pathogenesis: sensitization to aspergillus, intense IgE and IgG mediated immune response
- sx: recurrent exacerbations. Sx of pneumonia in asthma patient unresponsive to treatment
- dx:
- elevated Aspergillus-specific IgE
- elevated (eg, >417 IU/mL) total IgE
- positive Aspergillus-specific IgG
- eosinophilia
- positive skin test reactivity for Aspergillus.
- Consequently, the initial evaluation for ABPA should include either skin testing for Aspergillus or analysis of total and specific IgE concentrations.
- cxr: upper lobe opacities, atelectasis due to mucus plugging, and signs of bronchiectasis such as bronchial wall thickening.
- rx: steroids as this is hypersensitivity reaction
- sometimes supplemented by antifungal with azole
Backlinks
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Pulmonology
Pulmonology
MKSAP
Normal
Obstructive Lung Disease
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Aspergillosis
aspergillosis
Aspergillus
- most common species: A. fumigatus, A. flavus, A. niger, and the amphotericin-resistant A. terreus.
- Aspergillus produces disease after inhalation of airborne spores (90%) and only occasionally by traumatic skin inoculation. Of all the fungi, Aspergillus is notable for the diverse settings in which it can occur and the various clinical manifestations it can produce.
Types
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