https://doi.org/10.4081/monaldi.2023.2803
Allergic bronchopulmonary aspergillosis: radiological and microbiological profile of patients presented in an outpatient pulmonary clinic in a developing country
Submitted: October 7, 2023
Accepted: November 9, 2023
Published: December 7, 2023
Accepted: November 9, 2023
Abstract Views: 485
PDF_EARLY VIEW: 268
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
There is limited data available about allergic bronchopulmonary aspergillosis (ABPA) in Pakistan. The aim of the study was to describe the radiological and microbiological profile of ABPA patients presenting to the outpatient pulmonary clinic of a tertiary care hospital in Karachi, Pakistan. A retrospective study was conducted on ABPA patients who presented to the pulmonary outpatient clinic at Aga Khan University Hospital, Karachi, Pakistan, from January 2017 to December 2019. Data was collected on microbiology and radiology features on predesigned proforma. A total of 7759 asthmatic patients presented at the outpatient pulmonology clinic during the study period. Of the 245 patients labeled as ABPA, 167 fulfilled the inclusion criteria, and 91 (54.5%) were female (mean age 41.9±13.0 years). A high resolution computed tomography scan of the chest was available for 126 patients. Of these, 104 (82.5%) patients had bronchiectasis. Central bronchiectasis was noted in 98 (94.2%), mucus plugging in 71 (56.3%), and hyperinflation was seen in 30 (23.4%) patients. Microbiological testing was available in 103/167 (61.7%) patients. The most common bacterial pathogen was Pseudomonas aeruginosa 32 (31.1%), followed by Hemophilus influenzae 16 (15.5%), and Moraxella catarrhalis 7 (9.7%). Aspergillus fumigatus 17 (23.6%) was the most common mold, followed by Aspergillus flavus 16 (22.2%) and Aspergillus niger 11 (15.3%). Co-infection (bacterial and fungal) was found in 18 (17.45%) patients. Bronchiectasis was frequently observed in our cohort of patients with ABPA. Pseudomonas aeruginosa was found to be common among bacterial pathogens. Isolation of fungus is not uncommon in these patients.
Hassanzad M, Mortezaee V, Bongomin F, et al. Successful control of exacerbation of allergic bronchopulmonary aspergillosis due to Aspergillus terreus in a cystic fibrosis patient with short-term adjunctive therapy with voriconazole: a case report. J Mycol Med 2019;29:189-92.
DOI: https://doi.org/10.1016/j.mycmed.2019.02.001
Rosenberg M, Patterson R, Mintzer R, et al. Clinical and immunologic criteria for the diagnosis of allergic bronchopulmonary aspergillosis. Ann Intern Med 1977;86:405-14.
DOI: https://doi.org/10.7326/0003-4819-86-4-405
Wang JL, Patterson R, Rosenberg M, et al. Serum IgE and IgG antibody activity against Aspergillus fumigatus as a diagnostic aid in allergic bronchopulmonary aspergillosis. Am Rev Respir Dis 1978;117:917-27.
Agarwal R, Chakrabarti A, Shah A, et al. Allergic bronchopulmonary aspergillosis: review of literature and proposal of new diagnostic and classification criteria. Clin Exp Allergy 2013;43:850-73.
DOI: https://doi.org/10.1111/cea.12141
Amini B, El-Feky M, et al. Allergic bronchopulmonary aspergillosis. Reference Article. 2008. Available from: https://radiopaedia.org/articles/allergic-bronchopulmonary-aspergillosis.
Patil S, Patil R. “Fleeting pulmonary infiltrates in allergic bronchopulmonary aspergillosis” misdiagnosed as tuberculosis. Int J Mycobacteriol 2018;7:186-90.
DOI: https://doi.org/10.4103/ijmy.ijmy_57_18
Le Thuong V, Nguyen Ho L, Tran Van N. Allergic bronchopulmonary aspergillosis masquerading as recurrent bacterial pneumonia. Med Mycol Case Rep 2016;12:11-3.
DOI: https://doi.org/10.1016/j.mmcr.2016.06.004
Patterson R, Greenberger PA, Halwig JM, et al. Allergic bronchopulmonary aspergillosis: natural history and classification of early disease by serologic and roentgenographic studies. Arch Intern Med 1986;146:916-8.
DOI: https://doi.org/10.1001/archinte.146.5.916
Oguma T, Taniguchi M, Shimoda T, et al. Allergic bronchopulmonary aspergillosis in Japan: a nationwide survey. Allergol Int 2018;67:79-84.
DOI: https://doi.org/10.1016/j.alit.2017.04.011
Chakrabarti A, Sethi S, Raman DSV, Behera D. Eight-year study of allergic bronchopulmonary aspergillosis in an Indian teaching hospital. Mycoses 2002;45:295-9.
DOI: https://doi.org/10.1046/j.1439-0507.2002.00738.x
Angrill J, Agustí C, de Celis R, et al. Bacterial colonisation in patients with bronchiectasis: microbiological pattern and risk factors. Thorax 2002;57:15-19.
DOI: https://doi.org/10.1136/thorax.57.1.15
Denning DW, Pleuvry A, Cole DC. Global burden of allergic bronchopulmonary aspergillosis with asthma and its complication chronic pulmonary aspergillosis in adults. Med Mycol 2013;51:361-70.
DOI: https://doi.org/10.3109/13693786.2012.738312
Jabeen K, Farooqi J, Mirza S, et al. Serious fungal infections in Pakistan. Eur J Clin Microbiol Infect Dis 2017;36:949-56.
DOI: https://doi.org/10.1007/s10096-017-2919-6
Kumar R, Goel N. Allergic bronchopulmonary aspergillosis: a clinico-serological correlation with radiologic profile. J Asthma 2013;50:759-63.
DOI: https://doi.org/10.3109/02770903.2013.796973
Agarwal R, Khan A, Garg M, et al. Chest radiographic and computed tomographic manifestations in allergic bronchopulmonary aspergillosis. World J Radiol 2012;4:141-50.
DOI: https://doi.org/10.4329/wjr.v4.i4.141
Zhang M, Gao J. Clinical analysis of 77 patients with allergic bronchopulmonary aspergillosis in Peking union medical college hospital. Zhongguo Yi Xue Ke Xue Yuan Xue Bao 2017;39:352-7.
Lou B, Xu Z, Yang G, et al. Role of Aspergillus fumigatus-specific IgE in the diagnosis of allergic bronchopulmonary aspergillosis. Int Arch Allergy Immunol 2019;178:338-44.
DOI: https://doi.org/10.1159/000495365
Chowdhary A, Agarwal K, Kathuria S, et al. Allergic bronchopulmonary mycosis due to fungi other than Aspergillus: a global overview. Crit Rev Microbiol 2014;40:30-48.
DOI: https://doi.org/10.3109/1040841X.2012.754401
Agarwal R, Khan A, Aggarwal AN, et al. Clinical relevance of peripheral blood eosinophil count in allergic bronchopulmonary aspergillosis. J Infect Public Health 2011;4:235-43.
DOI: https://doi.org/10.1016/j.jiph.2011.08.006
Patterson R, Greenberger PA, Radin RC, Roberts M. Allergic bronchopulmonary aspergillosis: staging as an aid to management. Ann Intern Med 1982;96:286-91.
DOI: https://doi.org/10.7326/0003-4819-96-3-286
Greenberger PA, Yucha CB, Janson S, Huss K. Using rare diseases as models for biobehavioral research: allergic bronchopulmonary aspergillosis. Allergy Asthma Proc 2007;28:489-96.
DOI: https://doi.org/10.2500/aap.2007.28.3023
Edwards MR, Bartlett NW, Hussell T, et al. The microbiology of asthma. Nat Rev Microbiol 2012;10:459-71.
DOI: https://doi.org/10.1038/nrmicro2801
Shah A, Panjabi C. Allergic bronchopulmonary aspergillosis: a perplexing clinical entity. Allergy Asthma Immunol Res 2016;8:282-97.
DOI: https://doi.org/10.4168/aair.2016.8.4.282
Ethics Approval
The study protocol was approved by the Ethical Review Committee of the Aga Khan University Hospital. ERC number assigned 2019-0901- 2239.How to Cite
Iqbal, Nousheen, Muhammad Irfan, Mustafa Bin Ali Zubairi, Maaha Ayub, Safia Awan, Kausar Jabeen, and Ali Bin Sarwar Zubairi. 2023. “Allergic Bronchopulmonary Aspergillosis: Radiological and Microbiological Profile of Patients Presented in an Outpatient Pulmonary Clinic in a Developing Country”. Monaldi Archives for Chest Disease, December. https://doi.org/10.4081/monaldi.2023.2803.
Copyright (c) 2023 The Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- A.E. Erbaycu, Z. Taymaz, F. Tuksavul, A. Afrashi, S.Z. Güçlü, What happens when oral tuberculosis is not treated? , Monaldi Archives for Chest Disease: Vol. 67 No. 2 (2007): Pulmonary series
- U. Yılmaz, H. Halilcolar, I. Unsal, S. Yapıcıoglu, Y. Yıldırım, M. Apaydın, Isolated interrupted inferior vena cava with azygos continuation mimicking paraesophageal lymph node enlargement , Monaldi Archives for Chest Disease: Vol. 65 No. 4 (2006): Pulmonary series
- M. Lusuardi, F. Blasi, C. Terzano, C. Cricelli, N. Crispino, L. Comarella, F. De Benedetto, C.M. Sanguinetti, L. Allegra, C.F. Donner, Standards of care and clinical predictors in patients hospitalised for a COPD exacerbation - The Italian SOS (Stratification Observational Study) , Monaldi Archives for Chest Disease: Vol. 71 No. 4 (2009): Pulmonary series
- Sh. Karimi, F. Mohammadi, S. Pejhan, M. Bakhshayeshkaram, P. Akhavan-Azari, M. Bahadori, Hemomediastinum and bilateral hemothorax with extensive angiomatosis of anterior mediastinum , Monaldi Archives for Chest Disease: Vol. 65 No. 3 (2006): Pulmonary series
- Giovanni Rossi, Mario Perrillo, Martina Flora, Adriano Costigliola, Mariano Mollica, Carlo Iadevaia, Giampiero Gaio, Francesco S. Cerqua, Andrea Bianco, Fabio Perrotta, Incidental diagnosis and therapeutic approach of an iatrogenic intra-parenchymal pulmonary intercostal artery pseudoaneurysm: a case report , Monaldi Archives for Chest Disease: Vol. 89 No. 3 (2019)
- A. Voulgaridis, V. Apollonatou, D. Lykouras, A. Giannopoulos, M. Iliopoulou, K. Karkoulias, P. Kraniotis, C. Prokakis, M. Gkermpesi, K. Spiropoulos, Pleural Mesothelioma in a young male patient , Monaldi Archives for Chest Disease: Vol. 79 No. 2 (2013): Pulmonary series
- N. Boffin, V. Van der Stighelen, D. Paulus, P. Van Royen, Use of office spirometers in Flemish general practice: results of a telephone survey , Monaldi Archives for Chest Disease: Vol. 65 No. 3 (2006): Pulmonary series
- S.S. Dhillon, I.G. Berim, N. Khushalani, J. Gannon, Detection of a possible case of Pulmonary Tumour Thromboembolism by endobronchial ultrasound , Monaldi Archives for Chest Disease: Vol. 77 No. 1 (2012): Pulmonary series
- Elena Bargagli, Viola Bonti, Alessandra Bindi, Vieri Scotti, Massimo Pistolesi, Luca Voltolini, Katia Ferrari, Fibrotic lung toxicity induced by cytotoxic drugs, radiation and immunotherapy in patients treated for lung cancer , Monaldi Archives for Chest Disease: Vol. 88 No. 2 (2018)
- A. Zanini, S. Della Patrona, A.L. Facchini, A. Spanevello, Induced sputum in the management of COPD: clinical implications , Monaldi Archives for Chest Disease: Vol. 77 No. 1 (2012): Pulmonary series
<< < 7 8 9 10 11 12 13 14 15 16 > >>
You may also start an advanced similarity search for this article.
