1000/L)# Immediate wheal-and-flare response to Aspergillus fumigatus# Serum precipitins to A. fumigatus# Elevated serum IgE# Central bronchiectasisOther Diagnostic Features:# History of brownish plugs in sputum# Culture of A. fumigatus from sputum# Elevated IgE (and IgG) class antibodies specific for A. fumigatusAdditional Educational points:# The chest roentgenogram in ABPA may show transient, recurrent infiltrates or may suggest the presence of proximal bronchiectasis. High-resolution chest CT is a sensitive, noninvasive technique for the recognition of proximal bronchiectasis.# The bronchial asthma of ABPA likely involves an IgE-mediated hypersensitivity, whereas the bronchiectasis associated with this disorder is thought to result from a deposition of immune complexes in proximal airways. Adequate Rx usually requires the long-term use of systemic glucocorticoids.">