What other radiological findings are frequently encountered in patients with allergic bronchopulmonary aspergillosis (ABPA)?
Transient patchy areas of consolidation may be evident representing eosinophilic pneumonia, and are common.
How is the diagnosis of allergic bronchopulmonary aspergillosis (ABPA) made?
Identification of aspergillus in sputum is useful but as it is ubiquitous it is by no means pathognomonic, and in fact is only considered one of the 'minor' criteria. Major criteria consist of radiological evidence of central bronchiectasis and changes of pulmonary eosinophilia, a clinical history of asthma and laboratory evidence of blood eosinophilia, immediate skin reactivity to Aspergillus antigen and increased serum IgE.
What is the mainstay of treatment?
As Aspergillus is ubiquitous in the environment, the main focus of treatment revolves around managing asthma (corticosteroid play a major role), eradicating Aspergillus from the airway and thus preventing late complications e.g. severe bronchiectasis and fibrosis.
"Glove like" opacity in the right upper zone (yellow dotted line) represents sputum plugged bronchiectasis. Air-filled bronchiectasis is seen bilaterally (green arrows).