Question:medium
Which of the following is NOT a feature of allergic bronchopulmonary aspergillosis (ABPA)?
Which of the following is NOT a feature of allergic bronchopulmonary aspergillosis (ABPA)?
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ABPA is an allergy with fleeting infiltrates and very high IgE - it is not a repeated bacterial pneumonia.
Updated On: Jun 23, 2026
- High IgE level
- Recurrent pneumonia
- Occurrence in patients with old cavitary lesions
- Pleural effusion
Show Solution
The Correct Option is B
Solution and Explanation
Step 1: Anchor on the word "allergic": ABPA is an immune hypersensitivity to colonising Aspergillus in asthmatic or CF airways, so look for allergy markers, not infection markers.
Step 2: Run through the major criteria - asthma, fleeting infiltrates, blood eosinophilia $>1000/\mu L$, positive immediate skin test, A. fumigatus precipitins, total $IgE > 1000\ ng/mL$, and proximal bronchiectasis. "High IgE" therefore IS a feature.
Step 3: ABPA can seed old lung cavities (linking to aspergilloma), and a pleural effusion may rarely accompany the inflammatory infiltrate, so options c and d are compatible.
Step 4: The mismatch is "recurrent pneumonia" - ABPA produces transient allergic infiltrates, not repeated bacterial pneumonias, so it is the feature NOT seen.
\[\boxed{\text{Recurrent pneumonia}}\]
Step 2: Run through the major criteria - asthma, fleeting infiltrates, blood eosinophilia $>1000/\mu L$, positive immediate skin test, A. fumigatus precipitins, total $IgE > 1000\ ng/mL$, and proximal bronchiectasis. "High IgE" therefore IS a feature.
Step 3: ABPA can seed old lung cavities (linking to aspergilloma), and a pleural effusion may rarely accompany the inflammatory infiltrate, so options c and d are compatible.
Step 4: The mismatch is "recurrent pneumonia" - ABPA produces transient allergic infiltrates, not repeated bacterial pneumonias, so it is the feature NOT seen.
\[\boxed{\text{Recurrent pneumonia}}\]
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