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High attenuation mucoid impaction in allergic bronchopulmonary aspergillosis
Ritesh Agarwal, Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research Sector-12, Chandigarh 160012, India
Author contributions: Agarwal R conceived the idea and drafted the manuscript.
Correspondence to: Ritesh Agarwal, MD, DM, Assistant Professor, Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research Sector-12, Chandigarh 160012, India. riteshpgi@gmail.com
Telephone: +91-172-2756825 Fax: +91-172-2748215
Received: December 15, 2009
Revised: January 20, 2010
Accepted: January 22, 2010
Published online: January 28, 2010
Revised: January 20, 2010
Accepted: January 22, 2010
Published online: January 28, 2010
Abstract
Allergic bronchopulmonary aspergillosis (ABPA) is a complex hypersensitivity syndrome triggered against antigens of Aspergillus fumigatus, a fungus that most commonly colonizes the airways of patients with bronchial asthma and cystic fibrosis. It presents clinically with refractory asthma, hemoptysis and systemic manifestations including fever, malaise and weight loss. Radiologically, it presents with central bronchiectasis and recurrent episodes of mucus plugging. The mucus plugs in ABPA are generally hypodense but in up to 20% of patients the mucus can be hyperdense on computed tomography. This paper reviews the literature on the clinical significance of hyperattenuated mucus in patients with ABPA.
Keywords: Allergic bronchopulmonary aspergillosis; Mucoid impaction; Hyperdense mucus; High attenuation mucus; Aspergillus