DOC in allergic bronchopulmonary aspergillosis ABPA:
Ans: a (Prednisolone) Ref: Harrison, 16th ed, p. 1189; 17th ed, p. 1260, Table (197-2)Drug of choice for ABPA is prednisolone. (According to new recommendadation 17th ed, Harrison,Table 197-2 drug of choice is ITRACONAZOLE)Treatment of aspergillus infectionFungus ball of the lung - Surgical resectionABPA- short course of Glucocorticoids (prednisolone)Invasive Aspergillosis-voriconazole, liposomal or conventional amphotercin BMajor diagnostic criteria for ABPA:Secondary diagnostic criteria1. Clinical history of asthma1. History of brownish plugs in sputum2. Pulmonary infiltrates (transient or fixed)2. Culture of A. fumigatus from sputum3. Peripheral eosinophilia (> 1000/uL)3. Late skin reactivity to aspergillus antigen4. Immediate skin reactivity to aspergillus antigen.4. Elevated IgE (and IgG) class antibodies specific for A. fumigatus.5. Serum precipitates to A. fumigatus6. Elevated serum IgE levels.7. Central / proximal bronchiectasis(In recent papers lot of questions are asked regarding the antimicrobial of choice. Therefore we have listed some of the important ones.)Gonococcal infection- CeftriaxoneClostridium- Penicillin (IV) + ClindamycinDiphtheria- ErythromycinListeria- IV Ampicillin or PenicillinKlebsiella- CarbepenemCampylobacter- ErythromycinYersenia pestis- StreptomycinPertussis- ErythromycinBrucella- StreptomycinChlamydia- AzithromycinMycoplasma- Erythromycin
Prednisolone
IV Amphotercin B
IV Phenramine maleate
Fluconazole
Respiratory