Question:
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
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Verified By Collegedunia
The Correct Option is B
Solution and Explanation
Step 1: ABPA is a hypersensitivity (allergic) reaction to Aspergillus antigens colonising the airways, seen typically in atopic asthmatics and in cystic fibrosis. It is an allergic, not a true infective pneumonic, process.
Step 2: Its diagnostic hallmarks are a history of asthma, transient/fleeting pulmonary infiltrates, peripheral eosinophilia (>1000/uL), immediate skin reactivity to Aspergillus, serum precipitins to A. fumigatus, markedly elevated total serum IgE (>1000 ng/mL), and central/proximal bronchiectasis.
Step 3: "Recurrent pneumonia" (option b) is not a defining feature of ABPA - the infiltrates are allergic and fleeting rather than repeated bacterial pneumonias. So this is the EXCEPTION asked for and is the correct answer.
Step 4: The other options can be associated: high IgE is a core criterion, ABPA may colonise pre-existing cavities (overlap with aspergilloma in old cavitary lung disease), and pleural reactions/effusions can occasionally be seen, so they are not the odd one out.
Step 2: Its diagnostic hallmarks are a history of asthma, transient/fleeting pulmonary infiltrates, peripheral eosinophilia (>1000/uL), immediate skin reactivity to Aspergillus, serum precipitins to A. fumigatus, markedly elevated total serum IgE (>1000 ng/mL), and central/proximal bronchiectasis.
Step 3: "Recurrent pneumonia" (option b) is not a defining feature of ABPA - the infiltrates are allergic and fleeting rather than repeated bacterial pneumonias. So this is the EXCEPTION asked for and is the correct answer.
Step 4: The other options can be associated: high IgE is a core criterion, ABPA may colonise pre-existing cavities (overlap with aspergilloma in old cavitary lung disease), and pleural reactions/effusions can occasionally be seen, so they are not the odd one out.
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