Allergic bronchopulmonary aspergillosis (ABPA) caused by Aspergillus terreus: specific lymphocyte sensitization and antigen-directed serum opsonic activity.

A 16-year-old male presented with a history of asthma and recurrent pneumonia. A diagnosis of ABPA was based upon the typical clinical presentation, peripheral eosinophilia, elevated IgE and positive immediate skin tests to Aspergillus. Sputum cultures grew A. terreus, a rare cause of human disease. Soluble and particulate antigens were prepared from this organism. Precipitins against A. terreus, but not against A. fumigatus, were detected in the patient's serum. His lymphocytes proliferated markedly in vitro when exposed to soluble A. terreus but not A. fumigatus antigen. The lymphocyte responses correlated with disease activity. Functional serum opsonic activity was measured using the technique of stimulated polymorphonuclear leucocyte chemiluminescence. The nonspecific opsonic activity of the patient's serum was within high normal range when zymosan was employed as an alternative pathway activator. Specific opsonic activity against particulate Aspergillus antigen was significantly increased in the patient's serum when compared with control sera. Despite the presence of specific antibody and opsonic activity against A. terreus, the patient's serum levels of C3, C4, and total hemolytic complement were normal. These findings are consistent with in vivo sequestration of the organism.