Allergic bronchopulmonary aspergillosis and aspergilloma. Long-term follow-up without enlargement of a large multiloculated cavity.

A 47-year-old man with a history of mild asthma presented with hemoptysis attributed to a large multiloculated cavitary mycetoma. Peripheral blood eosinophilia of 43 percent led to the diagnosis of allergic bronchopulmonary aspergillosis (ABPA). Treatment of ABPA with prednisone led to resolution of an upper lobe infiltrate and a dramatic reduction in the total serum IgE level. Evaluation over a two-year period did not demonstrate enlargement of the cavity or disseminated aspergillosis.