📘 What is ABPA? (Allergic Bronchopulmonary Aspergillosis)

Patient handout for A&E staff who ask what aspergillosis is.

What is ABPA?

ABPA is an allergic lung condition caused by the immune system overreacting to the fungus Aspergillus. It mainly affects people with asthma or cystic fibrosis.

When Aspergillus spores are inhaled, most people clear them without issue. In ABPA, the immune system sees these spores as dangerous and mounts a strong inflammatory response. This leads to asthma-like symptoms, mucus plugging, and can result in permanent lung damage (bronchiectasis) if left untreated.

Symptoms

• Worsening breathlessness

• Wheezing, chest tightness

• Coughing up thick, often brown mucus

• Fever, fatigue, or feeling generally unwell

• Unintentional weight loss (advanced cases)

Diagnosis

• History of asthma or cystic fibrosis

• High IgE levels and positive Aspergillus-specific IgE

• Eosinophilia (raised white blood cells)

• Sputum culture or PCR positive for Aspergillus

• Chest imaging showing mucus plugging or bronchiectasis

Treatment

• Oral corticosteroids (e.g. prednisolone) to reduce inflammation

• Antifungal medication (e.g. itraconazole) to lower fungal burden

• Biologic therapies (e.g. omalizumab or benralizumab) in some patients

• Regular monitoring by respiratory or infectious diseases specialists

Key Points for A&E:

✅ ABPA is an allergic lung disease, not a classical infection
✅ Can present with severe asthma, mucus plugging, or type 2 respiratory failure
✅ Requires early recognition and often systemic steroids and antifungal therapy
✅ Take bloods (IgE, eosinophils, CRP), consider chest imaging, and review oxygen status

📍 For specialist support:

National Aspergillosis Centre (NAC)
🏥 Wythenshawe Hospital, Manchester University NHS Foundation Trust
🌐 NAC homepage on MFT website https://mft.nhs.uk/wythenshawe/services/infectious-diseases/national-aspergillosis-centre/
🌐 www.aspergillosis.org

📞 Daytime contact: 0161 291 2891 or 0161 291 4362
📞 Urgent out-of-hours: Call Wythenshawe switchboard on 0161 998 7070
📢 Ask for the on-call Infectious Diseases Consultant