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Asthma patients must avoid fungus: Pulmonologist advises.

HYDERABAD -- Allergic Broncho Pulmonary Aspergillosis ( ABPA), is an allergic lung reaction to a type of fungus that occurs in some people with asthma or cystic fibrosis, causing cough, wheezing and sometimes fever and if untreated, chronic lung damage may develop.

Talking to reporter here on Wednesday Pulmonologist Dr.Rashid Ahmed Khan has said the fungus Aspergillus fumigatus flourishes in soil, decaying vegetation, foods, dusts and water.

He said that the pulmonary Aspergillus is an allergic reaction to a fungus called Aspergillus's, which causes inflammation of the airways and air sacs of the lungs and it defined the Allergic Broncho Pulmonary Aspergillosis (ABPA).

Dr. Rashid said about the ABPA disease that the Aspergillus fungus is common and it can grow on dead leaves, stored grain, bird droppings, compost stacks and other decaying vegetation although most people are frequently exposed to Aspergillus, infections caused by it such as a pneumonia or fungus ball are rare.

He said that the disease may mimic asthma or pneumonia, and, in fact, most patients with ABPA have asthma as well. He said that the patients with asthma or cystic fibrosis are at highest risk for allergic Aspergillosis including worsening symptoms of asthma, wheezing, Cough may produce brownish plugs or bloody sputum, Fever, Chest X-ray, CT scan, chest and lung biopsy.

Dr. Rashid Ahmed informed that the people with predisposing factors (asthma, cystic fibrosis) should try to avoid environments where this fungus is found if possible.He said that ABPA, if not diagnosed and treated early, can cause life-threatening complications.But current diagnostician methods have been complicated by poorly characterized antigen mixtures that lacked sensitivity and specificity, but recent breakthroughs in the characterization, isolation, and purification of these antigens has the potential for greatly improving diagnosis, he added.

He said that the disease has been reported to occur mainly as complication in patients with asthma and cystic fibrosis, in whom the incidence may be as high as 10 percent and there are numerous clinical manifestations. Dr. Khan said that the effective treatment depends on early diagnosis and the institution of appropriate anti-inflammatory therapy.

He said that the ABPA disorder differs from typical pneumonia caused by bacteria, viruses and most fungi, in that the fungus does not actually invade the lung tissue and directly destroy it and the fungus colonizes the mucus in the airways of people with asthma or cystic fibrosis and causes recurrent allergic inflammation in the lung,added.

Dr. Rashid said that the first indications of ABPA are usually progressive symptoms of asthma, such as wheezing and shortness of breath, and a mild fever.

He said that the repeated chest x-rays show areas that look like pneumonia, but they appear to migrate to new areas of the lung, most often in the upper parts but long-standing disease. chest X-rays or computerized tomography (CT) may show widened airways, which are often plugged with mucus and appearance is similar to one that would be found in a person who has a lung tumor, he added.

About the treatment, Dr. Rashid said that because Aspergillus appears in many places in the environment, the fungus is difficult to avoid. Antiasthma drugs, especially corticosteroids, are used to treat allergic bronchopulmonary Aspergillosis. He said that in most patients, ABPA responds to steroids, but a small proportion of cases are refractory to treatment and progress to stage V disease.

Dr. Rashid Ahmed Khan said that the chronic necrotizing aspergillus's has a significant morbidity rate and if left untreated, this condition has a significant mortality rate. However, the precise incidences are unknown. The slow progression of clinical and aspergillus findings may contribute to a delay in diagnosis, he added.
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Publication:Balochistan Times (Baluchistan Province, Pakistan)
Date:May 10, 2018
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