Bronchopulmonary Aspergillosis

Bronchopulmonary aspergillosis is a complex pulmonary disorder caused by hypersensitivity to Aspergillus species, most commonly Aspergillus fumigatus, which colonizes the airways without direct tissue invasion. It typically occurs in individuals with asthma, cystic fibrosis, or other chronic lung diseases, where impaired airway clearance creates a favorable environment for fungal growth. Clinical manifestations include recurrent wheezing, productive cough with brownish plugs, fever, and worsening respiratory symptoms that may be mistaken for uncontrolled asthma or infection. Bronchopulmonary aspergillosis is diagnosed through a combination of clinical findings, radiographic changes such as fleeting pulmonary infiltrates or bronchiectasis, and laboratory evidence including elevated IgE levels, eosinophilia, and positive Aspergillus-specific tests. Treatment primarily involves systemic corticosteroids to reduce inflammation and immune hypersensitivity, often combined with antifungal agents such as itraconazole or voriconazole to reduce fungal load and prevent recurrence. Close monitoring of therapy is essential to balance efficacy with potential side effects, particularly during long-term corticosteroid or antifungal use. Patient education regarding adherence and early recognition of exacerbations plays a central role in management. Bronchopulmonary aspergillosis care often requires collaboration between pulmonologists, allergists, and infectious disease specialists to ensure comprehensive management. Advances in diagnostic techniques and targeted therapies are improving outcomes and reducing long-term complications, such as fibrosis and chronic respiratory impairment. By integrating accurate diagnosis, pharmacologic therapy, and multidisciplinary follow-up, bronchopulmonary aspergillosis management seeks to preserve lung function and enhance quality of life in affected individuals.