Date: 26 November 2013
This recording of peak flow was taken prior to and during the first 4 weeks of inhaled steroids (Becotide 100 and Duovent both 2 puffs 4x daily). The patient had had asthma since age 4, and been treated with bronchodilators and oral courses of steroids when severely affected. The chart, which the patient completed at home, shows that early in week one her peak flow varied from 200-250 L/min. As the medication started to work, the peak flows gradually increased to reach 360-420 L/min in the 4th week. The lower value each morning is characteristic of asthma.
The response to steroids is important confirmation of the diagnosis of asthma (reversible airways obstruction). Many years later she developed ABPA, while on inhaled steroids, with severe upper lobe central bronchiectasis, an IgE of 6,800 Kiu/L, positive aspergillus precipitins, an Aspergillus RAST of 58.7KUa/L (normal <0.4) and eosinophilia.
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Notes: n/a
Images library
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Clothing spreads Aspergillus spores – Scanning electron micrograph of Aspergillus niger spores on cotton fibres.
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Clothing spreads Aspergillus spores – Scanning electron micrograph of Aspergillus niger spores on wool fibres.
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A Colonies on MEA after one week;B conidial heads and tip of conidiophore, x 230; C conidial head, x920; E conidial head, x920. Copyright B.Flannigan, R Samson & JD Miller (From Microorganisms in home and indoor work environments, Published by Taylor and Francis)
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3 yr old boy with CNS aspergillosis pt TS. Scan 6 weeks post treatment.