Date: 26 November 2013
Further details
Image 5. Oral itraconazole pulse therapy was given to the patient (200 mg twice daily for 1 week, with 3 weeks off between successive pulses, for four pulses) and treatment was successful.
Copyright:
Image 1. Copyright Fungal Research Trust.
Image 2. Copyright B.Flannigan, R Samson & JD Miller (From Microorganisms in home and indoor work environments, Published by Taylor and Francis)
Images 3-5. With thanks to S Veraldi, A Chiaratti and H Harak Institute of Dermatological Sciences, University of Milan. Italy . These images remain the copyright of ‘Mycoses’ where the full article may be viewed. (Veraldi et al, published online Mycoses, 5th May 2009 http://www3.interscience.wiley.com/cgi-bin/fulltext/122374087/HTMLSTART).
Notes: n/a
Images library
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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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A typical example of a wet mount of a sputum sample from a patient with allergic bronchopulmonary aspergillosis.