Allergic Bronchopulmonary Aspergillosis Due To Aspergillus Niger Report Of Two Cases In Greece And Review Of The Literature

Two cases of allergic bronchopulmonary aspergillosis (ABPA) are reported. Both patients presented severe asthma, central bronchiectasis and fleeting infiltrates on computed tomography of the chest, immediate cutaneous reactivity to Aspergillus spp, elevated total serum IgE and elevated IgG and/or IgM Aspergillus antibodies. Bronchoalveolar lavage culture documented A. niger, a very rarely encountered fungus species in this entity. Although the incidence and rate of hospitalization for asthma have increased the last decades in Greece and skin sensitization to Aspergillus is described in 5% of greek atopic patients, ABPA is scarcely reported. Untreated ABPA results in recurrent exacerbations of airway inflammation, persistent asthma and can progress to advanced fibrotic changes. Therefore high clinical suspicion, early diagnosis and timely treatment and follow-up are considered significant in the course of this rare and underdiagnosed entity.