Allergic Bronchopulmonary Aspergillosis is Not Rare With a Note on Preparation of Antigen for Immunologic Tests

¹ Department of Medicine, University of Wisconsin Medical School, Madison, Wisconsin

This syndrome consists of asthma, recurrent pneumonia often with central bronchiectasis, eosinophilia, Aspergillus in the sputum, serum precipitins and positive skin tests both at 15 minutes and six hours. The clinical features of 14 patients are described. Antigens were prepared to 15 strains of A fumigatus. Different antigen preparations reacted differently in the precipitin test with different sera. No single preparation reacted with all patients with aspergillosis. Many commercially purchased antigens failed to react with sera containing small amounts of antibody or to elicit the six hour skin test reaction in some patients. To assure maximum sensitivity, tests for aspergillosis should include potent antigens from several strains of the organisms. Positive precipitin tests occurred in all six patients with invasive aspergillosis complicating malignant disease and were occasionally found in patients with chronic obstructive lung disease and other inflammatory diseases as well as in a few normal subjects. Dual positive skin test reactions were found in all 18 patients with aspergillomas and in 4 percent of healthy adults

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