- This is disease caused by the fungus Aspergillus
fumigatus and other fungi in the aspergillus family.
It is found in many places in the environment, including
compost piles, hay, dead leaves, and decaying vegetation.
Many people commonly inhale aspergillus spores, but
infection only rarely occurs -- usually when there
is a predisposing
- Invasive aspergillosis -- occurs in immunosuppressed individuals. Symptoms include cough, some chest pain with a deep breath, and shortness of breath. Examination reveals signs of Pneumonia --
e.g., crackles, broncheolar breath sounds, egophony.
- Endobronchial pulmonary
aspergillosis -- occurs in those with underlying lung disease, such as Sarcoidosis, Tuberculosis, or
bronchiectasis. Symptoms include a productive cough, often blood. Chest X-Ray may show an
aspergilloma (which is a large ball of fungal hyphae).
- Allergic Bronchopulmonary
aspergillosis -- this occurs in persons who already have Asthma. The Asthma worsens in response
to aspergillus. The lung exam will reveal increased wheezing
and peak flow meter readings will decrease. The blood count
reveals eosinophilia. Blood tests are also significant for
high levels of IgE, and aspergillus precipitins are present.
This disease tends to wax and wane and generally gets better
over time, though in some cases bronchiectasis and fibrotic
(scarred) lung disease may occur.
- Aspergillus sinusitis -- a ball of
hyphae (fungus) may block the sinus, or the fungus may
actually fibrose and inflame the tissue of the sinuses.
- Otomycosis -- aspergillus may grow
in the cerumen (wax) or debris of the ear canal.
- Aspergillus keratitis -- occurs
after trauma to the cornea of the eye.
- Endophthalmitis -- occurs after
trauma or surgery to the globe of the eye.
- Prostheses -- aspergillus may
infect artificial joints and heart
- Laboratory and examinations
- Biopsy of the affected tissue
provides best evidence of
- Invasive aspergillosis -- high-dose
Amphotericin B (lipid preparations often used)
- Itraconazole may also be an
alternative or considered in less severe disease.
- Allergic Bronchopulmonary
aspergillosis --Prednisone tapered over several months
(Itraconazole may be helpful and may decrease the amount of
- Aspergilloma -- surgical resection
is most effective. Itraconazole may be beneficial for some
- Aspergillus sinusitis -- surgical
debridement plus itraconazole
- Other conditions -- see the
appropriate specialist (e.g., ophthalmologist for
- Immuno-suppression (patients with a lowered immune
system) -- AIDS, cancer chemotherapy, high-dose
corticosteroids, and the use of cytotoxic drugs (e.g.,
Azathioprine), medications used after organ transplant
- Massive inhalation of aspergillus
by a person in good health
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