Aspergillosis refers to any infection with a fungus called Aspergillus.
The Aspergillus fungus is everywhere in the environment. It does not usually cause disease in healthy persons. Most cases of aspergillosis involve the lungs, but other parts of the body may be affected.
Aspergillus infection causes the body to produce an inflammatory response, or the lungs to have an allergic response.
Aspergillosis can occur in anyone, but there are three groups of people who are most likely to get the infection:
The main risks of the disease are worsening lung damage, respiratory problems, and even death.
Aspergillosis may cause a wide range of symptoms, including:
It is often difficult to make the diagnosis. The history and physical exam may cause the healthcare provider to suspect aspergillosis. Chest x-rays sometimes show certain abnormalities that suggest aspergillosis. A blood test called aspergillosis precipitin, and an aspergillosis antigen skin test can confirm the diagnosis.
Often, a tissue sample from the lungs is needed. This is usually obtained with a procedure called bronchoscopy. In bronchoscopy, a thin tube with a camera on the end of it is placed through the mouth and down into the lungs. Samples can be taken through the tube and are then sent to the lab to see if they contain Aspergillus.
Usually, nothing can be done to prevent the disease.
A person with asthma may develop chronic lung irritation due to Aspergillus. In others, aspergillosis may cause permanent damage to the lungs. It can also spread throughout the body and even result in death.
Aspergillosis is not contagious from person to person. People get the infection from the environment. Most people are exposed to Aspergillus early in life and have no problems with it.
Antifungal medications can be used to treat serious infections. A person with asthma often needs treatment to reduce inflammation and open up the airways. This treatment usually means corticosteroids, such as oral prednisone, instead of antifungal medications.
All medications have side effects. Common ones include allergic reactions and stomach upsets. The side effects depend on the medications used. Oral prednisone can cause stomach upset, water retention, weight gain, and high blood pressure. Long-term adverse effects include increased risk of bacterial infections, osteoporosis, and cataracts. The skin can become thinner and bruise more easily.
A person who recovers is often free to return to regular activities. Many people who get aspergillosis are quite sick and have other significant medical problems.
Symptoms can be followed, and physical exams and chest x-rays repeated. Blood tests or repeated bronchoscopy may also be needed.
Author:Adam Brochert, MD
Editor:Duff, Ellen, BA
Reviewer:H. William Kelly, PharmD
Cecil Textbook of Medicine, 1996, Bennett et al.