A 65-year-old woman was admitted to our hospital with a dry cough and pulmonary infiltrates. Chest radiograph and CT revealed mucoid impaction and consolidations. Peripheral blood eosinophilia and elevated serum IgE were observed. Aspergillus niger was cultured repeatedly from her sputum, but A. fumigatus was not detected. Immediate skin test and specific IgE (RAST) to Aspergillus antigen were positive. Precipitating antibodies were confirmed against A. niger antigen, but not against A. fumigatus antigen. She had no asthmatic symptoms, and showed no bronchial hyperreactivity to methacholine. Thus, this case was diagnosed as allergic bronchopulmonary aspergillosis (ABPA) without bronchial asthma due to A. niger, an organism rarely found in ABPA. The administration of prednisone improved the symptoms and corrected the abnormal laboratory findings.

Keywords:
Allergic bronchopulmonary aspergillosis, Aspergillus fumigatus, Aspergillus niger, Bronchial asthma
1.
Rosenberg M, Patterson R, Mintzer R, Cooper BJ, Roberts M, Harris KE: Clinical and immunologic criteria for the diagnosis of allergic bronchopulmonary aspergillosis. Ann Intern Med 1977;86:405–414.
2.
Slavin RG, Fischer VW, Levine EA, Tsai CC, Winzenburger P: A primary model of allergic bronchopulmonary aspergillosis. Int Arch Allergy Appl Immunol 1978;56:325–333.
3.
Glancy JJ, Elder JL, McAleer R: Allergic bronchopulmonary fungal disease without clinical asthma. Thorax 1981;36:345–349.
4.
Berkin KE, Vernon DRH, Kerr JW: Lung collapse caused by allergic bronchopulmonary aspergillosis in non-asthmatic patients. Br Med J 1982;285:552–553.
5.
McCarthy DS, Simon G, Hargreave FE: The radiological appearances in allergic broncho-pulmonary aspergillosis. Clin Radiol 1970;21:366–375.
6.
Yoshida N, Suguro H, Kohara F, Akiyama Y, Katoh H, Hashimoto N, Majima T, Yamaguchi M, Horie T, Kawabata Y: A case of allergic bronchopulmonary aspergillosis with no history of bronchial asthma. Nippon Kyobu Shikkan Gakkai Zasshi 1992;30:2123–2127.
7.
Greenberger PA, Patterson R: Allergic bronchopulmonary aspergillosis and the evaluation of the patient with asthma. J Allergy Clin Immunol 1988;81:646–650.
8.
Greenberger PA: Diagnosis and management of allergic bronchopulmonary aspergillosis. Allergy Proc 1994;15:335–339.
9.
Safirstein BH, D’Souza MF, Simon G, Tai E H-C, Pepys J: Five-year follow-up of allergic bronchopulmonary aspergillosis. Am Rev Respir Dis 1973;108:450–459.
10.
Henderson AH: Allergic aspergillosis: Review of 32 cases. Thorax 1968;23:501–512.
11.
Amitani R, Murayama T, Nawada R, Lee WJ, Niimi A, Suzuki K, Tanaka E, Kuze F: Aspergillus culture filtrates and sputum sols from patients with pulmonary aspergillosis cause damage to human respiratory ciliated epithelium in vitro. Eur Respir J 1995;8:1681–1687.
12.
Amitani R, Taylor G, Elezis E-N, Llewellyn-Jones C, Mitchell J, Kuze F, Cole PJ, Wilson R: Purification and characterization of factors produced by Aspergillus fumigatus which affect human ciliated respiratory epithelium. Infect Immun 1995;63:3266–3271.
1999
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.