Pulmonary Nontuberculous Mycobacteriosis and Chronic Lower Respiratory Tract Infections in Patients with Allergic Bronchopulmonary Mycosis without Cystic Fibrosis

Abstract

Objective The frequency of pulmonary nontuberculous mycobacteriosis (pNTM), chronic lower respiratory tract infections (cLRTIs), and pneumonia in patients with allergic bronchopulmonary mycosis (ABPM) without cystic fibrosis has not yet been fully investigated. Methods We retrospectively analyzed 42 patients with ABPM focusing on the frequency of pNTM and cLRTIs, acute exacerbation of cLRTIs, and pneumonia. Results During a median follow-up period of 2,299 days (range, 118-6,138 days), 7 patients developed pNTM (mainly Mycobacterium avium complex), and 21 patients developed cLRTI (mostly from Staphylococcus aureus followed by Pseudomonas aeruginosa). Twelve patients developed 21 episodes of acute exacerbation of cLRTIs, and 4 patients developed pneumonia. Conclusion Patients with ABPM can have concomitant NTM infection and, not uncommonly, cLRTI, and they can also sometimes develop pneumonia or an acute exacerbation of cLRTI.

Effectiveness and Safety of Omalizumab in Patients with Allergic Bronchopulmonary Aspergillosis Complicated by Chronic Bacterial Infection in the Airways

“…Non-cystic fibrosis ABPA is often complicated by chronic P. aeruginosa or nontuberculous mycobacterial infection of the lower respiratory tract. Ishiguro et al [12] reported that 7 (17%) of 42 patients with ABPM developed a nontuberculous mycobacterial infection and 21 (50%) had chronic lower respiratory tract infections caused by Staphylococcus aureus or P. aeruginosa . The presence of bronchiectasis and the use of high-dose corticosteroids administered by inhalation or systemically to treat ABPA are the possible predisposing factors for respiratory infections in these cases.…”

Treatment of allergic bronchopulmonary mycosis: Experience of 55 patients with 124 relapses—A descriptive study

“…An established guideline also recommended the addition of antifungal agents to SCSs to reduce the dose of SCSs; however, American allergologists have been reported to select certain treatment options other than SCSs with or without antifungals, indicating that physicians need treatment options that do not include SCSs. Previously, we reported that infectious events occur more frequently than expected in patients with ABPM, and there is concern that SCSs can increase or worsen these events . In fact, one male patient with ABPM in our hospital developed chronic progressive pulmonary aspergillosis during his clinical course.…”

Allergic Bronchopulmonary Mycosis Due to <i>Schizophyllum commune</i> Treated Effectively with Voriconazole

“…However, the long-term adverse effects of corticosteroid therapy may result in profound immunosuppression and debilitating metabolic abnormalities. It has been reported that pulmonary infection is not rare in ABPM patients due to the underlying impaired immune status ( 6 ). Furthermore, corticosteroid-induced immunosuppression may induce or very rarely result in progression of ABPA to invasive pulmonary aspergillosis ( 5 ).…”