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Aspergillosis

DEFINITION

Aspergillosis is an infection caused by a type of mold. The illnesses resulting from aspergillosis infection usually affect the respiratory system, but their signs and severity vary greatly. The mold that triggers the illnesses, aspergillus, is everywhere, 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 — invasive aspergillosis — 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.

CAUSES

Aspergillus mold is unavoidable. Outdoors, it’s found in decaying leaves and compost and on plants, trees and grain crops. Inside, the spores — the reproductive parts of mold — thrive in air conditioning and heating ducts, insulation, and some food and spices.

 

Everyday exposure to aspergillus is rarely a problem for people with healthy immune systems. When mold spores are inhaled, immune system cells surround and destroy them. But people who have a weakened immune system from illness or immunosuppressant medications have fewer infection-fighting cells. This allows aspergillus to take hold, invading the lungs and, in the most serious cases, other parts of the body.

Aspergillosis is not contagious from person to person.

SYMPTOMS

The signs and symptoms of aspergillosis vary with the type of illness you develop:

Allergic reaction
Some people with asthma or cystic fibrosis have an allergic reaction to aspergillus mold. Signs and symptoms of this condition, known as allergic bronchopulmonary aspergillosis, include:

  • Fever

  • A cough that may bring up blood or plugs of mucus

  • Worsening asthma



Fungal mass
A growth of tangled fungus fibers (fungus ball) may develop in air spaces (cavities) in the lung as part of chronic pulmonary aspergillosis. This type of aspergillosis is called simple aspergilloma. Lung cavities may develop in people with pre-existing lung conditions, such as emphysema, tuberculosis or advanced sarcoidosis.

Aspergilloma is a benign condition that may not produce symptoms or may produce a mild cough only, but over time, the underlying condition can worsen and possibly cause:

  • A cough that often brings up blood (hemoptysis), sometimes large amounts

  • Wheezing

  • Shortness of breath

  • Unintentional weight loss

  • Fatigue



Infection
Invasive pulmonary aspergillosis — the most severe form — occurs when the infection spreads rapidly from the lungs to your brain, heart, kidneys or skin. This occurs only in people whose immune system is weakened, commonly from chemotherapy. Untreated, this form of aspergilla disease is usually fatal.

Signs and symptoms depend on which organs are affected, but in general, invasive aspergillosis can cause:

  • Fever and chills

  • Cough that brings up blood-streaked sputum (hemoptysis)

  • Severe bleeding from your lungs

  • Shortness of breath

  • Chest or joint pain

  • Headaches or eye symptoms

  • Nosebleed

  • Facial swelling on one side

  • Skin lesions



Other types of aspergillosis
Aspergillus can invade areas of the body other than your lungs, such as your sinuses. In your sinuses, it can cause a stuffy nose, drainage that’s possibly bloody, inflammation, fever, facial pain and headache.

When to see a doctor

  • If you have asthma or cystic fibrosis, see your doctor whenever you notice a change in your symptoms. Although aspergillosis may not be the cause, it’s important to have 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, and treatment is sometimes started before the infection is diagnosed.

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