title: Allergic bronchopulmonary aspergillosis presenting with cough variant asthma and identifiable source of Aspergillus fumigatus.
abstract: BACKGROUND
  A 76-year-old man developed allergic bronchopulmonary aspergillosis initially presenting with cough variant asthma. Symptoms worsened 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 allergic bronchopulmonary aspergillosis presenting as cough variant asthma with identifiable source of Aspergillus fumigatus.
  
  
  METHODS
  Single case report. Serum precipitating antibodies against Aspergillus fumigatus were tested using gel diffusion techniques. Total IgE, specific IgE, and IgG indices were measured by ELISA. Cutaneous reactivity to Aspergillus fumigatus was also tested.
  
  
  RESULTS
  Skin test and serum precipitating 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.
  
  
  CONCLUSIONS
  Allergic bronchopulmonary aspergillosis can present as cough variant asthma. Identification of exacerbating factors such as sources of Aspergillus fumigatus are important in management.
authors.affiliation: Division of Allergy-Immunology, Northwestern Memorial Hospital, Chicago, Illinois, USA.
authors.forename: J
authors.initials: J
authors.lastname: Krasnick
authors.forename: R
authors.initials: R
authors.lastname: Patterson
authors.forename: M
authors.initials: M
authors.lastname: Roberts
mesh_terms: D000368:Aged; D001229:Aspergillosis, Allergic Bronchopulmonary / Q000150:complications / Q000175:diagnosis*; D001232:Aspergillus fumigatus / Q000302:isolation & purification*; D001249:Asthma / Q000175:diagnosis* / Q000209:etiology / Q000382:microbiology; D003371:Cough / Q000209:etiology* / Q000382:microbiology; D003937:Diagnosis, Differential; D004787:Environmental Pollution; D006801:Humans; D008297:Male