Date: 26 November 2013
Left= an agar air plate exposed for 2 minutes after the barley had been turned. showing numerous colonies of the fungus following incubation at 26C on 2% malt agar.Right= A sputum sample taken from a maltworker after exposure showing many fungal colonies when cultured on agar. His commensal yeast flora is seen towards the right base as cream/white colonies.
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High resolution CT scan images with reconstruction of 1mm thick slices at approximately 10mm increments. The scan shows moderately severe multi-lobar cylindrical and varicose bronchiectasis predominantly centrally and in the upper lungs. There is no mucus plugging seen.
The features are in keeping with allergic bronchopulmonary aspergillosis
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pt.SB – 6/10/98 – bronchocentric granulomatosis. CT scan showing multiple small nodules of variable size in both lung fields, apparently close to the vascular bundles.
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Bronchial oedema.Remarkably oedematous bronchial mucosa, as seen in ABPA.
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An example of longstanding allergic bronchopulmonary aspergillosis in a patient who has been steroid dependent for over 15 years showing remarkable kyphoscoliosis and honey combing and fibrosis of both lungs.
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Recurrent pulmonary shadows 1. 6 Jan 1988 – chest radiograph showing right hilar enlargement, consistent with ABPA.
Recurrent pulmonary shadows 1. 3 Feb 1989 – chest radiograph showing right upper-lobe consolidation and contraction consistent with obstruction of RUL bronchus, in ABPA.
Clearing of pulmonary shadows 3, pt BJ. 5 April 1989 – resolution of shadows seen in February, with a course of corticosteroids.
Recurrence of pulmonary shadows 4, pt BJ. 2 September 1989 – recurrence of pulmonary shadows with an exacerbation of ABPA.
Central bronchiectasis, pt BJ. CT scan of thorax October 1989 showing central bronchiectasis, characteristic of ABPA (and cystic fibrosis).
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