The most common x- ray findings are homogenous consolidation with or without atelectasis involving a segment or a lobe. Generally the upper lobes are most frequently involved. The white blood cell count is typically slightly elevated but there is marked increase in the peripheral eosinophil count. Most serum immunoglobulins are normal to slightly elevated except for IgE which will be markedly elevated. Patients tend to have frequent recurrent exacerbations with fever, cough, and purulent sputum production.
Prednisone is discontinued when serum IgE levels have fallen to normal or declined substantially.
At that point good surveillance is needed with prompt reinstitution of steroids for acute exacerbations. Aerosolized corticosteroids have been reported to be efficacious. Invasive bronchopulmonary aspergillosis occurs only in immunocompromised hosts. It is particularly common in patients with hematologic malignancies, aplastic anemia, collagen vascular disease, those on immunosuppressive drugs or steroids. McCarthy, D. Allergic bronchopulmonary aspergillosis.