Concurrent allergic bronchopulmonary aspergillosis and aspergilloma: is it a more severe form of the disease?

T he mould Aspergillus, a genus of spore forming fungi, affects the respiratory system in more ways than one. The clinical spectrum of Aspergillus involvement of the lungs ranges from various hypersensitivity manifestations to invasive disease which can be fatal. The inhaled spores hardly affect healthy persons but in asthmatic subjects these spores are trapped in the viscid secretions found in the airways. Repeated inhalation of Aspergillus antigens triggers allergic reactions in atopic individuals, which may manifest as Aspergillus-induced asthma, allergic bronchopulmonary aspergillosis (ABPA) and allergic Aspergillus sinusitis (AAS) [1]. Saprobic colonisation of airways, cavities and necrotic tissue leads to the development of aspergillomas.