Allergic Bronchopulmonary Aspergillosis due to Aspergillus niger. Report of two cases in Greece and review of the literature

摘要

Two cases of allergic bronchopulmonary aspergillosis(ABPA) are reported. Both patients presented severe asthma, centralbronchiectasis and fleeting infiltrates on computed tomography ofthe chest, immediate cutaneous reactivity to Aspergillus spp, elevatedtotal serum IgE and elevated IgG and/or IgM Aspergillus antibodies.Bronchoalveolar lavage culture documented A. niger, a very rarelyencountered fungus species in this entity. Although the incidenceand rate of hospitalization for asthma have increased the last decadesin Greece and skin sensitization to Aspergillus is described in 5% ofgreek atopic patients, ABPA is scarcely reported. Untreated ABPAresults in recurrent exacerbations of airway inflammation, persistentasthma and can progress to advanced fibrotic changes. Thereforehigh clinical suspicion, early diagnosis and timely treatment andfollow-up are considered significant in the course of this rare andunderdiagnosed entity.