What is Aspergillosis?

Aspergillosis is a syndrome of diseases caused by breathing in spores of the highly common fungus Aspergillus. Healthy people breathe the spores without a problem. Immune-compromised people and people with previous lung problems can develop a disorder when they breathe these fungal spores, however. Any part of the body can become infected, but a response is mostly found in the lungs and sinuses. Such an infection is treatable, except in cases of severe infection of people with highly compromised immune systems.

This fungus lives in the soil and on decaying plant matter, and its spores are ubiquitous in the air. When breathed in, they can trigger a strong response of the immune system, in people whose immune system does not work well. The most severe syndrome is invasive aspergillosis. This is seen with patients whose immune systems are highly compromised because of drug treatments to incapacitate them. An example is people who undergo bone marrow transplants.

With no immune system, the fungus is able to spread in their body. It can spread from the blood into other organs, such as the brain or eye. This infection can be fatal, so patients are usually kept in the hospital during their vulnerable periods. The symptoms of a severe Aspergillus infection can range from fever and chills, to liver and kidney failure.

Invasive pulmonary aspergillosis is also a disease of people with weakened immune systems. Such patients include those with AIDS, cancer, or undergoing chemotherapy or organ transplantation. In this case, the fungus has caused pneumonia that can spread to other parts of the body.

Diagnosis involves a computerized tomography (CT) scan or an X-ray. Infected material is analyzed for the presence of the fungus. Infection in the blood will result in the presence of fungal material, called galactomannan, that is a positive test for the fungus. If caught early, this condition is treatable with antifungal drugs.

Other types of aspergillosis are not life-threatening. Allergic bronchopulmonary aspergillosis (ABPA) is a condition in which the presence of the spores in the airway triggers a strong response of the immune system. This occurs in people who already have lung problems, such as asthma or cystic fibrosis. It causes inflammation of the airways and sometimes airway constriction.

The symptoms of this disease include the appearance of asthma that is poorly controlled. Patients chronically produce sputum, and may cough up brown plugs of mucus and possibly even blood. They may appear to have pneumonia, but not respond to antibiotics.

The lungs become scarred from irritation and may resemble cases of tuberculosis. The aspergillosis treatment in this case is corticosteroids to reduce the inflammation, along with antifungal treatment. Such patients will generally have a life-long infection, but it can be kept under control with treatment.

Another type of this fungal disease is chronic pulmonary aspergillosis (CPA). In this case, the lungs have previously been damaged. For instance, the patient may have had tuberculosis, and the fungus subsequently grew in the injured area. It can form a fungal ball known as an aspergilloma. This condition is not usually treated, unless it bleeds into the lung tissue. In which case it can be surgically removed.

The sinuses are another area that can be aggravated by Aspergillus spores. The response can range from an allergic response to the growth of a fungal ball within the sinuses. This type of aspergillosis is typically readily treated.