Aspergillosis

Pronounced: ASS-per-jill-OH-sis

by Ricker Polsdorfer, MD

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Definition | Causes | Risk Factors | Symptoms | Diagnosis | Treatment | Prevention

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Definition

Aspergillus is a common type of fungus. It is found all over the world. Aspergillosis is an infection caused by this fungus. It can result in severe lung problems.

While this type of infection is rare, it is more common in people with:

• Chronic lung disease
• HIV infection and AIDS
• Prolonged chemotherapy
• Steroid usage

Most of these condition weaken the immune system. The body is less able to fight off infections. In these cases, the fungus can spread to other organs. This can include the eye, sinuses, and brain. It is a serious condition that requires treatment.

Another form of aspergillosis affects people with asthma:

• Allergic bronchopulmonary aspergillosis —a type of allergic reactions to environmental agents

 

Causes

Inhaling fungus spores can be the first step to aspergillosis.

 

Risk Factors

The following factors increase your chance of developing aspergillosis:

• Compromised immunity
  • AIDS
  • Drugs that accompany an organ transplant
  • Certain cancer treatments
  • Long-term, high-dose cortisone-like drugs
  • Poorly functioning or too few white blood cells (neutropenia)
• Chronic lung disease
  • Bronchiolitis
  • Tuberculosis
  • Sarcoidosis
  • Histoplasmosis
• Asthma

 

Symptoms

If you have any of these symptoms, do not assume it is due to aspergillosis. These symptoms may be caused by other conditions. Tell your doctor if you have any of these:

• Chronic productive cough
• Coughing up blood
• Fever
• Shortness of breath
• Wheezing

 

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. You may be referred to a specialist in lung diseases or infectious diseases. Tests may include the following:

• Blood and urine samples
• Sputum samples
• Chest x-ray —a test that uses radiation to take a picture of structures inside the chest
• CT scan —a type of x-ray that uses a computer to make pictures of structures inside the body
• MRI scan —a test that uses magnetic waves to make pictures of structures inside the body
• Bronchoscopy —visual examination of the air passages leading into the lungs

 

Treatment

The underlying disease must be treated along with the aspergillosis. Talk with your doctor about the best plan for you. Treatment options include:

• Medicine
  • Intravenous Amphotericin B—given for a prolonged period of time; may damage the kidneys
  • Voriconazole —found to be highly effective for invasive aspergillosis and a preferred treatment option
  • Itraconazole —effective in some cases
• Surgery—Part of the lung may need to be removed if it contains a large mass of fungus.

 

Prevention

Aspergillus is everywhere. This makes it very difficult to avoid it. The best step is to avoid the conditions that are associated with it.

 RESOURCES:

The Aspergillus Website
http://www.aspergillus.org.uk/

Center for Disease Control
http://www.cdc.gov/

 CANADIAN RESOURCES:

The Canadian Lung Association
http://www.lung.ca/home-accueil_e.php/

Health Canada
http://www.hc-sc.gc.ca/index_e.html/

REFERENCES:

Aspergillosis. DynaMed website. Available at: http://www.dynamicmedical.com/dynamed.nsf?opendatabase . Accessed October 4, 2005.

Beers MH, Berkow R, eds. The Merck Manual . 17th ed. West Point, PA: Merck & Co;1999.

Bennett JE. Aspergillosis. In: Kasper DL, et al., eds. Harrison's Principles of Internal Medicine . 16th ed. New York: McGraw-Hill; 2005:1188-1190.

Mandell GL, Bennet JE, Dolin R, eds. Principles and Practices of Infectious Diseases . 6th ed. St. Louis, MD, Consult; 2005.

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Last reviewed January 2010 by David L. Horn, MD, FACP
Last Updated: 1/15/2010