A Clinical Evaluation of Definitive and Clinical Allergic Bronchopulmonary Mycosis

Objective The present study aims to overcome problems associated with the early diagnosis of allergic bronchopulmonary mycosis (ABPM) using the current criteria. Patients and Methods Clinical features including radiographic findings from 10 patients with definitive ABPM based on the diagnostic criteria of Rosenberg-Patterson were compared with those from 9 patients with ABPM clinically diagnosed by respiratory allergy specialists. Results ABPM should be considered in patients with peripheral blood eosinophilia and pulmonary infiltration and/or central bronchiectasis when serum total IgE is elevated. Complication by bronchial asthma suggested ABPM, but was not essential. The expectoration of sputum containing solid components was a critical factor in patients with a history in ABPM. Evaluation of sputum cultures, serum specific IgE antibodies, skin tests and precipitating antibodies were required to establish a diagnosis, but the positive rate of these tests remained low. Conclusions Even when a definitive diagnosis cannot be established, systemic corticosteroid therapy should be initiated for clinically diagnosed ABPM to prevent irreversible pulmonary dysfunction.