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Aspergillosis

more about Aspergillosis


  • 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 condition.

  • 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 valves.

  • Laboratory and examinations described above
  • Biopsy of the affected tissue provides best evidence of infection.

  • 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 prednisone needed).
  • Aspergilloma -- surgical resection is most effective. Itraconazole may be beneficial for some individuals.
  • Aspergillus sinusitis -- surgical debridement plus itraconazole
  • Other conditions -- see the appropriate specialist (e.g., ophthalmologist for keratitis)

  • 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
  • Asthma




more about Aspergillosis


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