Allergic Bronchopulmonary Aspergillosis

Abstract

Allergic bronchopulmonary aspergillosis implies that only local growth in the proximal airways takes place without actual invasion of the wall of the bronchus or more distal pulmonary tissue parenchyma. When colonization of the airways takes place as determined by environmental and host physiological and immunological factors, it serves as a strong enough stimulus to elicit a local and systemic immunological response from the patient. The cellular and glandular responses of the bronchi result in the formation of mucoid collections of eosinophils and mycelia, effecting airway obstruction. The mucus plugs can in most cases account for the atelectasis and x-ray findings of recurrent infiltrates characteristically seen in different parts of the lungs of these patients. In addition, the patients develop blood eosinophilia and positive skin and serum precipitin tests to aspergillus antigens, the demonstration of which is essential for diagnosis. The available therapy in the form of corticosteroids, while nonspecific, results in gratifying therapeutic responses. The availability of an effective mode of therapy and evidence showing that chronic infection leads to complications and progressive lung destruction therefore require early diagnosis and treatment.