- By sahlhealth
- May 18, 2021
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Aspergillosis is an infection caused by a type of mold. The illnesses resulting from Aspergillosis usually affect the respiratory system, but their signs and severity vary greatly.The mold that triggers the illnesses, Aspergillus, is everywhere â€” indoors and outdoors. Most strains of this mold are harmless, but a few can cause serious illnesses when people with weakened immune systems, underlying lung disease or asthma inhale their spores.In some people, the spores trigger an allergic reaction. Other people develop mild to serious lung infections. The most serious form of Aspergillosis â€” invasive Aspergillosis â€” occurs when the infection spreads to blood vessels and beyond.Depending on the type of Aspergillosis, treatment may involve observation, antifungal medications or, in rare cases, surgery.
The signs and symptoms of Aspergillosis vary with the type of illness you develop:
-Some people with asthma or cystic fibrosis have an allergic reaction to Aspergillus. Signs and symptoms of this condition, known as allergic bronchopulmonary Aspergillosis, include:
- A cough that may bring up blood or plugs of mucus
- Worsening asthma
-Certain chronic lung (pulmonary) conditions, such as emphysema, tuberculosis or advanced sarcoidosis, can cause air spaces (cavities) to form in the lungs. When people with lung cavities are also infected with Aspergillus, fungus fibers may find their way into the cavities and grow into tangled masses (fungus balls) known as Aspergillomas. Aspergillomas may produce no symptoms or cause only a mild cough at first. Over time and without treatment, however,Aspergillomas can worsen the underlying chronic lung condition and possibly cause:
- A cough that often brings up blood (hemoptysis)
- Shortness of breath
- Unintentional weight loss
-This is the most severe form of Aspergillosis. It occurs when the infection spreads rapidly from the lungs to the brain, heart, kidneys or skin. Invasive pulmonary Aspergillosis occurs only in people whose immune systems are weakened as a result of cancer chemotherapy, bone marrow transplantation or a disease of the immune system. Untreated, this form of Aspergillosis may be fatal.
-Signs and symptoms depend on which organs are affected, but in general, invasive Aspergillosis can cause:
- Fever and chills
- A cough that brings up blood (hemoptysis)
- Shortness of breath
- Chest or joint pain
- Headaches or eye symptoms
- Skin lesions
Other types of Aspergillosis
-Aspergillus can invade areas of your body other than your lungs, such as your sinuses. In your sinuses, the fungus can cause a stuffy nose sometimes accompanied by drainage that may contain blood. Fever, facial pain and headache may also occur.
When to see a doctor
-If you have asthma or cystic fibrosis, see your doctor whenever you notice a change in your breathing. Although Aspergillosis may not be the cause, it's important to have breathing problems evaluated.If you have a weakened immune system and develop an unexplained fever, shortness of breath or a cough that brings up blood, get immediate medical care. In the case of invasive Aspergillosis, prompt treatment is crucial. In some cases, treatment with antifungal medication begins as soon as Aspergillosis is suspected, even before testing has pinpointed the diagnosis.
-Diagnosing an Aspergilloma or invasive Aspergillosis can be difficult. Aspergillus is common in all environments but difficult to distinguish from certain other molds under the microscope. The symptoms of Aspergillosis are also similar to those of other lung conditions such as tuberculosis.
-Your doctor is likely to use one or more of the following tests to pinpoint the cause of your symptoms:
- Imaging test. A chest X-ray or computerized tomography (CT) scan â€” a type of X-ray that produces more-detailed images than conventional X-rays do â€” can usually reveal a fungal mass (Aspergilloma), as well as characteristic signs of invasive and allergic bronchopulmonary Aspergillosis.
- Respiratory secretion (sputum) test. In this test, a sample of your sputum is stained with a dye and checked for the presence of Aspergillus filaments. The specimen is then placed in a culture where mold is likely to grow. If the amount of Aspergillus increases in the culture, the test is positive.
- Tissue and blood tests. Skin, sputum and blood tests may be helpful in confirming allergic bronchopulmonary Aspergillosis. For the skin test, a small amount of Aspergillus antigen is injected into the skin of your forearm. If your blood has antibodies to the mold, you'll develop a hard, red bump at the injection site. Blood tests look for high levels of certain antibodies, which indicate an allergic response.
- Biopsy. In some cases, examining a sample of tissue from your lungs or sinuses under a microscope may be necessary to confirm a diagnosis of invasive Aspergillosis.
-Aspergillosis treatments vary with the type of disease. Possible treatments include:
- Observation. Simple, single Aspergillomas often don't need treatment, and medications aren't usually effective in treating these fungal masses. Instead, Aspergillomas that don't cause symptoms may simply be closely monitored by chest X-ray. If the condition progresses, then antifungal medications may be recommended.
- Oral corticosteroids. The goal in treating allergic bronchopulmonary aspergillosis is to prevent existing asthma or cystic fibrosis from worsening. The best way to do this is with oral corticosteroids. Antifungal medications by themselves aren't helpful for allergic bronchopulmonary Aspergillosis, but they may be combined with corticosteroids to reduce the dose of steroids and improve lung function.
- Antifungal medications. These drugs are the standard treatment for invasive pulmonary Aspergillosis. The most effective treatment is a newer antifungal drug, voriconazole (Vfend). Amphotericin B is another option.All antifungal drugs can have serious side effects, including kidney and liver damage. Interactions between antifungal drugs and other medications are also common.
- Surgery. Because antifungal medications don't penetrate aspergillomas very well, surgery to remove the fungal mass is the first-choice treatment when an Aspergilloma causes bleeding in the lungs.
- Embolization. This procedure stops lung bleeding caused by an Aspergilloma. A radiologist injects a material through a catheter that has been guided into an artery feeding a lung cavity where an Aspergilloma is causing blood loss. The injected material hardens, blocking the blood supply to the area and stopping the bleeding. This treatment works temporarily, but the bleeding is likely to start again.