If you have aspergillosis, especially ABPA (Allergic Bronchopulmonary Aspergillosis) and bronchiectasis, it can be hard to know which one is flaring up when your lungs feel worse. They often overlap — but there are some clues that can help.
🔍 How the Two Conditions Are Different
| Feature | ABPA Flare (Allergic Reaction to Aspergillus) | Bronchiectasis Flare (Infection in Damaged Airways) |
|---|---|---|
| Main cause | Your immune system reacting to Aspergillus | Infection in widened, inflamed airways |
| Symptoms you may notice | – Chest tightness or wheezing – Thick, sticky mucus – Feeling more tired – Occasional low-grade fever |
– Wet cough with more sputum – Sputum changes colour (green/yellow) – Fever, chills, or general unwell feeling |
| How it starts | May come on gradually or after exposure to damp/mould | Often starts after a cold or virus |
| What helps most | Steroids (inhaled or oral), sometimes biologics | Antibiotics and chest physiotherapy |
| What tests may show | – Raised IgE or eosinophils – CT may show mucus plugs |
– Raised CRP or white cells – Sputum may grow bacteria or fungus |
| What to ask your doctor | “Is my IgE or eosinophil count up?” | “Do I need a sputum test or antibiotics?” |
🧭 What Can You Do as a Patient?
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📝 Keep a symptom diary – especially note changes in:
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Sputum colour or amount
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Wheezing or chest tightness
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Tiredness or sleep quality
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🧪 Ask for the right tests:
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Blood tests like IgE and eosinophils for ABPA
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CRP, white blood count, and sputum tests for bronchiectasis
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🩺 Don’t guess or self-treat – steroids and antibiotics work in different ways, and using the wrong one can make things worse or mask important signs.
💬 Final Thought
It’s very common for people with aspergillosis to feel confused by flare-ups — you’re not alone. Learning to spot your own patterns, and getting support from your specialist team, can make a real difference.
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