Allergic bronchopulmonary aspergillosis (ABPA) is an uncommon diagnosis for Romanian pneumologist. The cause may be the absence of imunological techniques in current practice, an important step for ABPA confirmation. We present five cases of ABPA, in which diagnosis was established on clinical criteria - history of bronchial asthma and brownish plugs in sputum, radiologic findings - central bronchiectasis, pulmonary infiltrates -, and laboratory criteria - eosinophilia, culture of Aspergillus spp. in sputum or bronchoalveolar lavage (BAL), elevated serum Ig E. All patients (four men and a women) have benefit by BAL for diagnosis reasons. We observed an important, clinical improvement regarding dyspnoea, cough and sputum volume, after bronchoscopy, in all patients. They received asthma-like treatments associated with antifungal drugs, for one or two-year follow- up (2003- 2004). In our cases, we consider bronchoscopy such an effective procedure for diagnosing fungal infection, but for local therapy too. After bronchial washing and BAL mucoid impaction diminuated and clinical status improved. The procedure have to be performed according to evolution.
Full conference title:
15th European Respiratory Society annual conference
- ERS 15th (2005)