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Aspergillus Infection - Aspergillosis


Overview, Causes, & Risk Factors

Aspergillosis refers to any infection with a fungus called Aspergillus.

What is going on in the body?

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.

What are the causes and risks of the infection?

Aspergillosis can occur in anyone, but there are three groups of people who are most likely to get the infection:

  • those with immune system problems, such as a person with AIDS or cancer
  • those with old lung damage, usually from a tuberculosis lung infection or a genetic disease called cystic fibrosis
  • those with long-standing asthma, who may be allergic to Aspergillus or have an asthma attack when exposed to Aspergillus
  • The main risks of the disease are worsening lung damage, respiratory problems, and even death.


    Symptoms & Signs

    What are the signs and symptoms of the infection?

    Aspergillosis may cause a wide range of symptoms, including:

  • cough
  • coughing up blood
  • chest pain
  • fever
  • trouble breathing, including shortness of breath
  • weight loss
  • fatigue
  • wheezing or having an asthma attack

  • Diagnosis & Tests

    How is the infection diagnosed?

    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.


    Prevention & Expectations

    What can be done to prevent the infection?

    Usually, nothing can be done to prevent the disease.

    What are the long-term effects of the infection?

    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.

    What are the risks to others?

    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.


    Treatment & Monitoring

    What are the treatments for the infection?

    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.

    What are the side effects of the treatments?

    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.

    What happens after treatment for the infection?

    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.

    How is the infection monitored?

    Symptoms can be followed, and physical exams and chest x-rays repeated. Blood tests or repeated bronchoscopy may also be needed.


    Attribution

    Author:Adam Brochert, MD
    Date Written:
    Editor:Duff, Ellen, BA
    Edit Date:04/27/00
    Reviewer:H. William Kelly, PharmD
    Date Reviewed:08/29/01

    Sources

    Cecil Textbook of Medicine, 1996, Bennett et al.


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