Patient education: Allergic bronchopulmonary aspergillosis (The Basics)

What is allergic bronchopulmonary aspergillosis? — Allergic bronchopulmonary aspergillosis (called "ABPA" here) is an allergic reaction that can cause coughing, wheezing, and other symptoms. It usually happens in people who have asthma or cystic fibrosis. These lung conditions make it hard to breathe.

People who get ABPA are allergic to a fungus called "aspergillus." This allergy is more serious than an allergy to pollen or pets. ABPA can cause scars to form in the airways of the lungs. This can make asthma or other conditions worse.

What are the symptoms of ABPA? — The symptoms include:

●Coughing up mucus (sometimes the mucus has brown specks in it)

●Wheezing or noisy breathing

●Fever

●Feeling sick

A few people who get ABPA cough up blood, but not everyone does.

Should I see a doctor or nurse? — If you are coughing up blood, call your doctor or nurse. Call for an ambulance (in the US and Canada, call 9-1-1) if you have a severe asthma attack and your symptoms:

●Get worse

●Do not get better after using a quick-relief medicine

Will I need tests? — Yes. Your doctor or nurse will do an exam and learn about your symptoms. They can also order the following tests:

●Chest X-ray – This might show changes in the lungs caused by ABPA.

●CT scan of the chest – This is an imaging test that uses a special X-ray to create pictures of the inside of the body. It can show more details than a regular X-ray.

●Breathing tests – For these tests, you breathe hard into a tube. The tests show how well your lungs are working.

●Skin test – In this test, the doctor or nurse will put a tiny bit of an extract of aspergillus on your skin. Then they will make a tiny prick in the skin. The aspergillus is not alive, and it has been treated so it cannot make you sick. After 15 or 20 minutes, you might get a red, itchy bump like a mosquito bite. If you do, it means you are allergic to the fungus and ABPA might be causing your symptoms. If you do not get a bump, you probably do not have ABPA.

●Blood test – This can show if your body's infection-fighting system, called the "immune system," shows signs of an allergy to aspergillus.

How is ABPA treated? — ABPA is treated with medicines. These can include:

●Steroid medicines, such as prednisone (brand name: PredniSONE) – Steroids help reduce inflammation in the lungs. They come as pills or in a shot. These are not the same steroids that some athletes take illegally to build muscle.

●Medicines to kill the fungus that causes aspergillosis – These include itraconazole (brand name: Sporanox) or voriconazole (brand name: Vfend).

●Asthma medicines – Most people also need medicines to treat their asthma. These include inhaled "bronchodilator" medicines like albuterol (brand names: ProAir HFA, Proventil HFA, Ventolin HFA), inhaled steroids, and inhalers that contain both a bronchodilator and a steroid. If you take medicines for asthma, it's important to know when and how to use them properly.

Your doctor or nurse will do blood tests every few months to see if the ABPA is getting better. You might also have X-rays to check your lungs.

More on this topic

Patient education: Asthma in adults (The Basics)
Patient education: Medicines for asthma (The Basics)
Patient education: Cystic fibrosis (The Basics)
Patient education: Coughing up blood (The Basics)

Patient education: Shortness of breath (dyspnea) (Beyond the Basics)
Patient education: Trigger avoidance in asthma (Beyond the Basics)