Allergic bronchopulmonary aspergillosis

[Cami]

Allergic bronchopulmonary aspergillosis is an allergic lung reaction to a type of fungus (most commonly Aspergillus fumigatus) that occurs in some people with asthma or cystic fibrosis.

People may cough and wheeze, and they sometimes have fever or cough up flecks of blood.
Doctors use chest x-rays, blood tests, and skin tests to make a diagnosis.
Drugs used in the treatment of asthma, especially corticosteroids, are usually given.
Despite successful treatment, symptoms can recur periodically.
If uncontrolled, chronic lung damage may develop.

The fungus Aspergillus fumigatus flourishes in soil, decaying vegetation, foods, dusts, and water. Certain people who inhale the fungus may become sensitized and develop a chronic allergic reaction. Other fungi, including Penicillium, Candida, Curvularia, and Helminthosporium, can cause an identical illness. In some people, the effects of the allergic reaction combine with the effects of the fungus to damage the airways and lungs.
Allergic bronchopulmonary aspergillosis differs from pneumonia. Pneumonias are lung infections that are usually caused by bacteria, viruses, and most fungi. In allergic bronchopulmonary aspergillosis, in contrast, the fungus does not actually invade the lung tissue and directly destroy it. The fungus colonizes the mucus in the airways of people with asthma or cystic fibrosis (both of whom tend to have increased amounts of mucus) and causes recurrent allergic inflammation in the lung. The tiny air sacs of the lungs (alveoli) become packed primarily with eosinophils (a type of white blood cell). Increased numbers of mucus-producing cells may also appear. If the disease has caused extensive damage, inflammation may cause the central airways to widen permanently, a condition called bronchiectasis. Eventually, the lungs are likely to become scarred.
Other forms of aspergillosis can occur. Aspergillus can invade the lungs and cause serious pneumonia in people with an impaired immune system. This condition is an infection, not an allergic reaction. Aspergillus can also form fungus balls (aspergillomas) in cavities and cysts of lungs damaged by another disease, such as tuberculosis, and severe bleeding may result.