Clinical profile of 35 patients with
allergic bronchopulmonary aspergillosis (ABPA) was analysed. The disease was found to be more frequent among females. Constitutional symptoms, expectoration, increased breathless and poor control of
asthma were the main presenting features. Skin reactivity against
aspergillin and Candida was positive in 30 and 2 cases, respectively. Precipitating
antibodies against Aspergillus species was positive in 28 cases, and against Candida albicans in 2 cases. Sputum grew either Aspergillus or C. albicans or both in 19 patients. Absolute
eosinophilia was observed only in one third of cases. Chest skiagram revealed characteristic central/proximal
bronchiectasis and/or fleeting shadows in all cases. No specific pattern was observed on spirometry. There was no correlation between the duration of
bronchial asthma, sputum culture and serology results. Most patients responded well to
steroids. One striking feature of the study was that one third of the cases were misdiagnosed as
pulmonary tuberculosis and were treated with
antitubercular drugs for varying periods of time. A high index of clinical suspicion with appropriate laboratory tests are required to identify these cases.