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Vita health A-Z

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Aspergillosis

Aspergillus is a common fungus that can be found in indoor and outdoor environments. Most people breathe in Aspergillus spores every day without being affected. Aspergillosis is a disease caused by this fungus and usually occurs in people with lung diseases or weakened immune systems. The spectrum of illness includes allergic reactions, lung infections, and infections in other organs.
Fungal infections pose an increasing threat to public health for several reasons.

Definition of Aspergillosis
What is Aspergillosis?
Aspergillosis is an infection caused by a fungus called Aspergillus. There are several different kinds of aspergillosis. One kind is allergic bronchopulmonary aspergillosis (also called ABPA), a condition where the fungus causes allergic respiratory symptoms, such as wheezing and coughing, but does not actually invade and destroy tissue in the body. Another kind of aspergillosis is invasive aspergillosis, a disease that usually affects people with weakened immune systems. In this condition, the fungus invades and damages tissues in the body. Invasive aspergillosis most commonly affects the lungs, but Aspergillus can spread throughout the body and also cause infection in other organs.

What is Aspergillus?
Aspergillus is a fungus that is common in the environment. It is found in soil, on plants, and in decaying organic matter. It is also found in household dust and building materials. There are many different species of Aspergillus, but the most common species are Aspergillus fumigatus and Aspergillus flavus. Other species are Aspergillus terreus, Aspergillus nidulans, and Aspergillus niger.

Symptoms of aspergillosis
What are the Symptoms of aspergillosis?
The symptoms of aspergillosis depend on where in the body the fungus is growing. aspergillosis most commonly affects the sinuses or lungs. Symptoms of sinus infections include fever, headache, and sinus pain. Lung infections with the fungus can cause fever and cough.

Skin infections can develop after the fungus enters through a break in the skin caused by surgery, burns, or trauma. A skin infection can look like blisters or ulcers, and the infected tissue may turn black. Other symptoms of a skin infection include fever and tenderness, pain, heat, excessive redness, or swelling around a wound.
If the infection is not treated quickly, the fungus can spread throughout the body, and the infection is often fatal.
aspergillosis can present in different ways depending on the type of infection.

Risk & Prevention
People at Risk For Aspergillosis
Who Gets Aspergillosis?
Allergic bronchopulmonary aspergillosis (ABPA) can affect people who are otherwise healthy, but it is most common in people with asthma or cystic fibrosis. Invasive aspergillosis generally affects people who have weakened immune systems, such as people who have had a bone marrow transplant or solid organ transplant, people who are taking high doses of corticosteroids, and people who are getting chemotherapy for cancer. Rarely, people with advanced HIV infection can also get invasive aspergillosis.

How Can I Prevent Aspergillosis?
It is difficult to avoid breathing in normal levels of Aspergillus spores. For people with weakened immune systems or severe lung diseases, there are steps that can be taken to help reduce exposure, including:

  • Wear an N95 mask when near or in a dusty environment such as construction sites
  • Avoid activities that involve close contact to soil or dust, such as yard work or gardening
  • Use air quality improvement measures such as HEPA filters
  • Take prophylactic antifungal medication if deemed necessary by your healthcare provider
  • Clean skin injuries well with soap and water, especially if the injury has been exposed to soil or dust

Diagnosis & Testing of Aspergillosis
How is Aspergillosis Diagnosed?
Healthcare providers consider risk factors, symptoms, and physical examination when diagnosing aspergillosis.  They may also perform imaging tests when necessary, such as chest x-rays or CT scans of the lungs and other organs. Biopsies of affected tissue or samples of respiratory secretions might be analyzed in a laboratory for evidence of the fungus under a microscope or through fungal culture. Other tests are available to monitor high-risk people for invasive aspergillosis, such as those with severely weakened immune systems.

Treatment & Outcomes of Aspergillosis
How is Aspergillosis Treated?
Aspergillosis requires treatment with antifungal medication prescribed by a doctor. Voriconazole is currently the first-line treatment for invasive aspergillosis. There are other medications that can be used to treat invasive aspergillosis in patients who cannot take voriconazole or who have not responded to voriconazole. These include itraconazole, lipid amphotericin formulations, caspofungin, micafungin, and posaconazole. Whenever possible, immunosuppressive medications should be discontinued or decreased.