Aspergillosis

Overview

Aspergillosis is an infection caused by a specific type of mold known as aspergillus, which is present both indoors and outdoors. While many strains of this mold are harmless, certain varieties can lead to significant health issues, primarily affecting the respiratory system. The severity and symptoms of illnesses resulting from aspergillosis infection can vary widely.

The mold called aspergillus that can cause illnesses is found all around us – both inside our buildings and outside. While most forms of this mold aren’t dangerous, a couple of them can lead to serious sickness, especially for people with weaker immune systems, existing lung issues, or asthma, when they breathe in the mold’s tiny seeds.

There are different types of aspergillosis:

• Allergic Reaction: Some individuals with asthma or cystic fibrosis can experience an allergic reaction to aspergillus mold, known as allergic bronchopulmonary aspergillosis.
• Aspergilloma: In the presence of certain chronic lung conditions like emphysema, tuberculosis, or advanced sarcoidosis, lung cavities may form. Aspergilloma occurs when the aspergillus infection enters these cavities and develops into masses called fungus balls.
• Invasive Aspergillosis: Invasive aspergillosis is the most severe form, characterized by the rapid spread of the infection from the lungs to organs like the brain, heart, kidneys, or skin. It typically affects individuals with weakened immune systems due to factors like cancer chemotherapy or bone marrow transplantation.
• Other Types of Aspergillosis: Aspergillus can also invade areas beyond the lungs, such as the sinuses. This can lead to symptoms like a stuffy nose, drainage, and even facial pain or headaches.

Treatment for aspergillosis may involve observation, the use of antifungal medications, or, in rare cases, surgical intervention. The approach varies depending on the specific type of infection.

Symptoms

The signs and symptoms of these illnesses depend on the specific form of aspergillosis a person develops.

Allergic Reaction (Allergic Bronchopulmonary Aspergillosis):

• Fever
• Cough with potential blood or mucus plug expulsion
• Aggravated asthma

Aspergilloma: Aspergillomas might initially be asymptomatic or lead to only a mild cough. Progression can lead to:

• Coughing up blood (hemoptysis)
• Wheezing
• Shortness of breath
• Unintentional weight loss
• Fatigue

Aspergilloma: Aspergillomas might initially be asymptomatic or lead to only a mild cough. If left untreated, progression can lead to:

• Coughing up blood (hemoptysis)
• Wheezing
• Shortness of breath
• Unintentional weight loss
• Fatigue

Invasive Aspergillosis: Occurs in weakened immune systems Symptoms depend on affected organs:

• Fever and chills
• Coughing up blood (hemoptysis)
• Shortness of breath
• Chest or joint pain
• Headaches or eye symptoms
• Skin lesions

Other Types of Aspergillosis: Impact beyond lungs, especially sinuses. Symptoms include:

• Nasal congestion with blood-tinged drainage
• Fever
• Facial pain
• Headaches

If you have asthma or cystic fibrosis and you notice a change in your breathing, it’s important to see your doctor. Even though the cause might not be aspergillosis, getting your breathing problems checked is necessary.

If your immune system is weak and you suddenly have a fever, trouble breathing, or cough with blood, seek medical help right away. For invasive aspergillosis, quick treatment is very important. Sometimes, doctors start antifungal medicine when they suspect aspergillosis, even before confirming it with tests.

Causes

Aspergillosis, caused by various Aspergillus fungi, with A. fumigatus being the most common, typically affects individuals with weakened immune systems or chronic lung issues. While Aspergillus is present in the environment and commonly inhaled, healthy immune systems usually fend off the fungus. Nonetheless, those with compromised immunity are vulnerable as the mold can colonize the lungs and potentially spread to other body parts. Although widespread in nature, aspergillosis isn’t contagious among individuals.

Risk factors

Factors that increase the susceptibility to aspergillosis include:

• Weakened immune system: Individuals with suppressed immunity due to post-transplant medication, certain cancers like blood cancers, or advanced AIDS stages are at high risk.
• Low white blood cell count: People who’ve had treatments like chemotherapy, organ transplants, or have conditions like leukemia or chronic granulomatous disease are more vulnerable.
• Long-term corticosteroid use: Prolonged corticosteroid therapy, based on the underlying condition and concurrent medications, can elevate the risk of opportunistic infections.
• Lung cavities: Those with existing air spaces in their lungs have an elevated risk of aspergillomas.
• Asthma or cystic fibrosis: Individuals with longstanding, uncontrolled asthma or cystic fibrosis have a higher likelihood of allergic reactions to aspergillus mold.