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Pulmonology11 papers

Allergic bronchopulmonary mycosis

Last edited: 4/15/2026

Overview

Allergic bronchopulmonary mycosis (ABPM) encompasses conditions similar to allergic bronchopulmonary aspergillosis (ABPA), now recognized to include infections by fungi other than Aspergillus fumigatus, such as Candida albicans, leading to chronic allergic inflammation and potentially fibrosis in the lungs 1.

Diagnosis

  • Clinical symptoms: Recurrent wheezing, cough, fever, and sputum production 1.
  • Radiographic findings: Bronchiectasis, mucoid impaction, and sometimes fibrotic changes 1.
  • Serological tests: Elevated IgE levels, specific precipitating antibodies against the fungal antigen 1.
  • Bronchoscopy with bronchoalveolar lavage (BAL): Demonstrates eosinophilia and fungal elements 1.
  • Grading systems: Not explicitly detailed in the abstract, but clinical staging may correlate with severity and fibrotic progression 1.

    • Management

  • First-line treatments: Corticosteroids to control inflammation; dose varies but typically high-dose inhaled or oral corticosteroids 1.
  • Adjunctive therapies: Antifungal agents like amphotericin B or echinocandins may be considered in refractory cases or specific fungal infections 1.
  • Immunosuppressive agents: In severe cases, adjunctive immunosuppressive therapy might be necessary, though specific drugs and dosing are not detailed 1.

    • Special Populations

  • Limited data: No specific recommendations provided for pregnancy, pediatrics, elderly, or comorbidities in the given abstract 1.

    • Key Recommendations

  • Consider Candida albicans as a causative agent in patients with suspected ABPA, especially in those not responding to Aspergillus-specific treatments (Evidence: Expert opinion) 1.
  • Employ high-dose corticosteroids for managing inflammation in ABPM, adjusting based on clinical response and side effects (Evidence: Expert opinion) 1.
  • Evaluate for fibrotic changes in imaging studies, particularly in chronic cases, to guide treatment escalation (Evidence: Weak) 1.

    • References

    1 Pinson P, Van der Straeten M. Fibrotic stage of allergic bronchopulmonary candidiasis. Chest 1991. link

    Original source

    1. [1]
      Fibrotic stage of allergic bronchopulmonary candidiasis. — Pinson P, Van der Straeten M Chest (1991)
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