Breathing in a certain type of fungus
can cause a negative reaction called allergic bronchopulmomary aspergillosis
(ABPA). It tends to occur in people with chronic lung conditions, such as
asthma and cystic fibrosis.
Medications can help control it, but
it’s important to regularly monitor your lungs because this condition can get
What Causes It?
Aspergillus fumigates is a fungus.
It’s found in several places, including soil, water, and dust. ABPA occurs when
you breathe in this fungus. It causes a chronic reaction that leads to
recurring inflammation of the lungs.
The Cystic Fibrosis Foundation reports that ABPA occurs in roughly 2
to 11 percent of people with cystic fibrosis. One study found ABPA in around 13 percent of
asthma clinics. It's also more common in adolescents and males.
What Are the Symptoms?
The symptoms of ABPA resemble the
symptoms that occur with cystic fibrosis or asthma. For that reason, people who
have these conditions often don’t realize there may be an additional problem.
The first signs of ABPA often include:
- shortness of
- mild fever
- coughing up
mucus with brownish flecks
Other symptoms include coughing up
larger amounts of mucus and experiencing asthma attacks brought on by exercise.
How Serious Is It?
In severe cases, ABPA can cause
permanent changes to your central airways. They can become wider, which leads
to bronchiectasis. This condition can cause serious breathing problems or heart
failure. These complications occur more often in people with advanced cystic
How Is It Diagnosed?
Your doctor will perform several tests
to check if you have ABPA. Diagnosing this condition can be hard because the
symptoms it causes are very similar to those of cystic fibrosis and asthma.
Your doctor will also have to rule out other possible causes, such as
pneumonia. The tests your doctor might use include:
- chest X-rays
or CT scans to look for widened airways (CT scans use several X-rays to create
a detailed image of your lungs)
- blood tests to
check for high levels of antibodies that are fighting Aspergillus and white
blood cells called eosinophils
(phlegm) culture to look for Aspergillus and eosinophils
- skin test to
check for an allergy to Aspergillus, though it won't be able to tell the
difference between ABPA and a regular allergy to the fungus
How Is It Treated?
Treating ABPA involves reducing the
symptoms when flare-ups occur and trying to prevent them from happening again.
Your doctor will prescribe
corticosteroids, such as prednisone, to help with lung inflammation. You can
take these in pill or liquid form. You’ll likely be on it for several weeks
before your doctor weans you off them gradually. You’ll usually stop taking them
completely when the symptoms have disappeared. You might experience side
effects such as weight gain, an increased appetite, and an upset stomach from
Your doctor might also prescribe
asthma medications that help your airways open so that you have room to cough
up mucus. This helps remove the fungus from your airways.
Treating the Fungus
Your doctor might have you take an
antifungal medication, such as itraconazole, to get rid of as much of the
fungus in your airways as possible. This can help prevent ABPA from getting
worse. You’ll use it up to two times per day for up to six months unless your
symptoms go away before then. You might have side effects such as a fever,
upset stomach, or a rash.
Even if your symptoms disappear before
your prescription runs out, never stop taking your medication without asking
your doctor. You want to make sure you fully treat the condition and lessen the
risk of a reoccurrence.
Can It Be Prevented?
Exposure to Aspergillus is very hard
to avoid since the fungus is found in several common environments. Taking your
prescribed medications might help prevent recurring flare-ups.
What Is the Outlook?
ABPA can lead to increased damage to
your lungs without causing your symptoms to become worse. For this reason, your
doctor will regularly check your lungs and airways with chest X-rays and
pulmonary function (breathing) tests. Your doctor will also monitor your
antibody and eosinophil levels. With careful monitoring, you can prevent ABPA
from getting worse.