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Pseudomonas and Aspergillosis
- Question
- My 19 years old daughter has been recently treated with IV antibiotics for the first time for Pseudomonas primo-infection. At the end of the antibiotic treatment, she was diagnosed with aspergillosis (presumably ABPA) with high IgE levels (1500). After intitiating treatment with oral steroids, IgE went down to 1000 Ui/l. I have the following questions:
-Is there a risk of ABPA flare when decreasing the dosage of oral steroids?
-Is there a risk of recurrent Pseudomonas infection? Do steroids promote infection (my daughter has increased sputum production these days) - Answer
- Dear questioner,
Oral steroid is the main therapy for ABPA and reduce bronchial damage related to ABPA. The fact that total IgE are reduced after steroid treatment probably indicates efficacy of steroids. Of course, there is a risk of APBA flare when decreasing the dosage of oral steroids. Further steroids may promote bacterial infection, which may require increased use of antibiotics. Adaptation of steroid therapy should be discussed directly with your CF physician.
Best regards,
Dr Pierre-Régis Burgel - 25.11.2014
