ABPA

Question

Our son has aspergillosis. It has already been treated with cortisone, Sempera®, Vfend, the whole range.

After the therapy the course was stable for a couple of months. Currently, he has an acute exacerbation. The exacerbation occured exactly one day after having been treated by the physiotherapist in her partice. In the large rooms of the pratice there are some plants in the waiting area. Is it possible that ABPA was triggered by that? Should we change the practice? (the interior cannot be changed since the therapist is not the owner of it and has no influence on it).

Thank you for your answer.

Answer

Hello,

you report that your son who has a problem with ABPA had a new exacerbation one day after the treatment in the practice of a physiotherapist where plants are standing in the waiting area.
Altogether it is surely difficult to document an assured causal relation. To begin with it would be interesting to know if your son was treated in this practice for the first time on this day or if he was treated there several times before a while ago. If he was treated there several times before, such a correlation is rather unlikely.
Generally speaking, all plants (hydroponics as well as regular potted plants) should be removed from all rooms that belong to the treatment area of patients, especially pulmonary patients.
Contact with Aspergillus fumigatus can hardly be avoided in daily life of course. As you know the fungus is everywhere in the ground, in humid leaves, in builder’s dust but also in a humid autumnal forest. This makes it more difficult to relate the plants in the practice to the exacerbation of ABPA. If the plants are only in the waiting area maybe you could arrange that your son would not have to wait in the waiting area but would be taken directly to the well aired treatment room.

Best regards,
Dr. H.-G. Posselt

16.11.2009