ALLERGIC BRONCHOPULMONARY ASPERGILLOSIS PRESENTING WITH COUGH VARIANTASTHMA AND IDENTIFIABLE SOURCE OF ASPERGILLUS-FUMIGATUS

Background: A 76-year-old man developed allergic bronchopulmonary aspe rgillosis initially presenting with cough variant asthma. Symptoms wor sened after exposure to ground mulch which was an identifiable source of Aspergillus fumigatus. Symptoms improved after corticosteroids and avoidance measures were instituted. Objective: To report a case of all ergic bronchopulmonary aspergillosis presenting as cough variant asthm a with identifiable source of Aspergillus fumigatus.Methods: Single ca se report. Serum precipitating antibodies against Aspergillus fumigatu s were tested using gel diffusion techniques. Total IgE, specific IgE, and IgG indices were measured by ELISA. Cutaneous reactivity to Asper gillus fumigatus was also tested. Results: Skin test and serum precipi tating antibodies to Aspergillus fumigatus were positive. Precipitins were also detected between Aspergillus fumigatus and the mulch. Total serum IgE was 538 IU/mL (1290 ng/mL) which declined to 228 IU/mL (544 ng/mL) after corticosteroid therapy. IgE index = 1.10 and IgG index = 2.86, Conclusion: Allergic bronchopulmonary aspergillosis can present as cough variant asthma. Identification of exacerbating factors such a s sources of Aspergillus fumigatus are important in management.