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ABPA in Cystic Fibrosis — RACP Paediatrics MCQ

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HardRespiratoryABPA in Cystic FibrosisRACP Paediatrics

A 9-year-old with cystic fibrosis is found to have Aspergillus fumigatus on sputum culture. His total IgE is 1200 IU/mL and specific IgE to Aspergillus is positive. He has new pulmonary infiltrates not responding to antibiotics. What condition has developed?

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Correct answer: E — Allergic bronchopulmonary aspergillosis (ABPA)

ABPA in CF is diagnosed when total IgE is elevated (>500 IU/mL or significant rise), specific Aspergillus IgE or precipitins are positive, and there is clinical/radiological deterioration. Treatment includes systemic corticosteroids and antifungal therapy (itraconazole or voriconazole).

Reference: Australian Cystic Fibrosis Guidelines – 2024 – ABPA in CF