Eight-year study of allergic bronchopulmonary aspergillosis in an Indian teaching hospital

• Published in: Mycoses 2002-10, Vol.45 (7-8), p.295-299
• Main Authors: Chakrabarti, A., Sethi, S., Raman, D. S. V., Behera, D.
• Format: Article
• Language: English
• Subjects: ABPA; Adolescent; Adult; Antibodies, Fungal - blood; Aspergillose; aspergillosis; Aspergillosis, Allergic Bronchopulmonary - diagnosis; Aspergillosis, Allergic Bronchopulmonary - epidemiology; Aspergillosis, Allergic Bronchopulmonary - microbiology; Aspergillus; Aspergillus flavus - isolation & purification; Aspergillus fumigatus - isolation & purification; Biological and medical sciences; Culture Media; Epidemiologie; epidemiology; Female; Hospitals, Teaching; Human mycoses; Humans; India - epidemiology; Infectious diseases; Male; Medical sciences; Middle Aged; Mycoses; Mycoses of the respiratory system; Retrospective Studies; Skin Tests; Sputum - microbiology; Tropical medicine
• ISSN: 0933-7407; 1439-0507
• DOI: 10.1046/j.1439-0507.2002.00738.x

A total of 651 patients with clinically suspected allergic bronchopulmonary aspergillosis (ABPA) were evaluated during the 8‐year period from January 1991 to December 1998. Overall, 338 cases (51.9%) were positive either by sputum microscopy/culture (66 of 203 patients), by skin reactivity (150 of 309 cases), or by precipitating antibodies (122 of 338 patients) against Aspergillus species. However, in 89 patients, diagnosis of ABPA was confirmed on the basis of Rosenberg's criteria. Clinical profile and laboratory findings of those patients were analysed. The disease was found to be more common among males. Poor control of asthma, constitutional symptoms, mucopurulent expectoration, increased dyspnoea and wheezing and rhonchi were the main presenting features. Skin reactivity against aspergillin was seen in 73 (82%), precipitating antibodies against Aspergillus species were positive in 64 (72%) and sputum microscopy/culture was positive in 56 (63%) of those 89 patients. Central bronchiectasis and fleeting shadows were the most common radiological findings. This study highlights the importance of ABPA in north India and draws attention to the need for further analysis of criteria to use in the diagnosis of patients with ABPA. Zusammenfassung.  Von 651 Patienten des Zeitraums Januar 1991 bis Dezember 1998 mit klinischem Verdacht auf allergische bronchopulmonale Aspergillose (ABPA) waren insgesamt 338 (51.9%) entweder mikroskopisch und/oder kulturell in Sputumproben Aspergillus‐positiv (66 von 203 Patienten) oder in Hautreaktionen (150 von 309 Patienten) oder im Nachweis präzipitierender Anti‐Aspergillus‐Antikörper (122 von 338 Patienten). Bei 89 Patienten wurde Diagnose ABPA auf Grund der Rosenberg‐Kriterien gestellt. Die Krankheit war bei Männern häufiger. Asthma, verminderter Allgemeinzustand, mukopurulentes Sputum, erhöhte Dyspnoe, Keuchen und Rasselgeräusche waren die Haupsymptome. Bei dem Rosenberg‐Teilkollektiv waren 73 (82%) in der Hautreaktion gegen Aspergillin positiv, 64 (72%) hatten präzipitierende Anti‐Aspergillus‐Antikörper, und 56 (63%) waren mikroskopisch und/oder kulturell Aspergillus‐positiv. Zentrale Bronchiektasien und flüchtige Verschattungen waren die häufigsten radiologischen Befunde. Die Studie akzentuiert die epidemiologische Bedeutung von ABPA in Nordindien.