Aspergillosis is an infection or an allergic response
caused by a fungus of the Aspergillus type. It may play a role in allergy, but
is best known for causing serious pulmonary infections in immunocompromised
patients

 

It causes illness in three ways:

 

as an allergic reaction in people with asthma

 

as a colonization and growth in a lung injury (such as from
tuberculosis or lung abscess)

 

as an invasive systemic infection with pneumonia, nasal
necrosis or aural inflammation and necrosis that is spread to other parts of the
body by the bloodstream (pulmonary aspergillosis - invasive type).

 

Symptoms

 

Allergic aspergillosis

Fever

Malaise

Coughing

Coughing up blood or brownish
mucous plugs

Wheezing

Weight loss

Recurrent episodes of lung
obstruction

 

Invasive infection

Fever

Chills

Headaches

Cough

Shortness of breath

Chest pain

Increased sputum production, which
may be bloody

Bone pain

Blood in the urine

Decreased urine output

Weight loss

Symptoms involving specific organs

Brain: meningitis

Eye: blindness or visual
impairment

Sinuses: sinusitis

Heart: endocarditis

 

Signs and tests

 

Abnormal chest X-ray or CT scan

Sputum stain and culture showing Aspergillus

Tissue biopsy (see bronchoscopy with transtracheal biopsy)
for aspergillosis

Aspergillus antigen skin test

Aspergillosis precipitin antibody or galactomannan
positivity

Elevated serum total IgE (immunoglobulin)

Peripheral eosinophilia with allergic disease

 

Treatment

intravenous amphotericin B, an antifungal medication.

Itraconazole can also be used, or its newer counterpart
voriconazole.

Caspofungin may be tried when other drug therapy has
failed.

 

Endocarditis caused by Aspergillus is treated by surgical
removal of the infected heart valves and long-term amphotericin B therapy.

 

Allergic aspergillosis is treated with oral prednisone.