Table 1 Criteria for diagnosis of fungal allergic airways diseases associated with severe asthma and their complications

Allergic bronchopulmonary aspergillosis (ABPA)

1. Asthma or cystic fibrosis^a

2. Fleeting or fixed pulmonary opacities on chest radiograph

3. Peripheral eosinophil count > 500 cells/µL

1. Type I Aspergillus skin test positive (immediate cutaneous hypersensitivity reaction to Af) or elevated IgE levels against A. fumigatus,

2. Elevated total IgE levels more than 1000 IU/mL (unless all other criteria is met, then total IgE levels can be less than 1000 IU/mL)

3. Elevated Aspergillus IgG or precipitating antibodies

None

Bronchiectasis

Hyper-attenuated mucous

Asthma exacerbations

ABPA exacerbations

Bronchiectasis exacerbations

Fixed airways obstruction

Chronic pulmonary aspergillosis

Focal pleural based fibrosis areas

Allergic fungal airways disease (AFAD) or Airways Mycosis

Asthma with sensitization and/or inflammation and tissue damage including radiological abnormalities and fixed airways obstruction

Positive immediate skin test (SPT) and fungal specific IgE

Documented (PCR or culture) or presumed

Bronchial wall thickening

Bronchiectasis

Fixed airways obstruction

Severe asthma with fungal sensitisation (SAFS)

Severe asthma

Positive immediate skin test (SPT) and specific IgE to Aspergillus fumigatus, Alternaria alternata, Cladosporium herbarum, Penicillium chrysogenum, Candida albicans, Trichophyton mentagrophytes, or Botrytis cinereal

None

Asthma exacerbations

Bronchial wall thickening

Fixed airways obstruction

Chronic pulmonary aspergillosis

Aspergillus bronchitis^#

Non-immunocompromised Major symptoms of cough, breathlessness and sputum production

Bronchiectasis common

May have a raised Aspergillus fumigatus IgG

Culture or PCR positive for Aspergillus on at least 2 occasions separated in time (to exclude colonisation)