Aspergillosis: Information & Aspergillosis Specialists

In some people, the mold triggers an allergic reaction. Others develop a mild or severe lung infection. The most dangerous form of aspergillosis spreads to the blood vessels and continues to spread through them.

The signs and symptoms of aspergillosis vary depending on the type of aspergillosis.

Allergic aspergillosis

People with asthma and cystic fibrosis may have an allergic reaction to Aspergillus. Signs and symptoms of this condition, known as allergic aspergillosis, include:

• Fever
• Cough with phlegm
• worsening asthma

Fungal growth

In this form of aspergillosis, fungal growths develop in the lungs. It primarily affects people with pre-existing lung conditions, such as

• emphysema,
• tuberculosis, or
• advanced sarcoidosis.

Symptoms do not appear suddenly. However, over time, the following symptoms may develop, which could indicate aspergillosis:

• Cough with copious sputum
• Wheezing
• Shortness of breath
• unintentional weight loss
• Weakness

Pulmonary aspergillosis

The most severe form of aspergillosis is invasive pulmonary aspergillosis. In this case, the infection spreads rapidly from the lungs to other organs.

People with weakened immune systems, such as cancer patients undergoing chemotherapy, are particularly at risk.

Invasive aspergillosis can cause the following symptoms:

• Fever and chills
• Cough with sputum
• Bleeding in the lungs
• Shortness of breath
• Chest pain
• Nosebleeds
• Swelling on one side of the face
• Facial wounds

When should you see a doctor?

Patients with asthma or cystic fibrosis should see a doctor as soon as they notice any changes in their symptoms.

People with a weakened immune system should see a doctor if they experience

• sudden onset of fever,
• shortness of breath, and
• a cough with phlegm

.

In the case of invasive aspergillosis, timely treatment is of the utmost importance. It is usually initiated as a precautionary measure even before aspergillosis has been definitively diagnosed.

Aspergillus mold—the cause of aspergillosis—is very widespread. Outdoors, it can be found on fallen leaves, compost, plants, trees, and grains.

Indoors, it can be spread through ventilation systems, on heating units and insulation, as well as in food and spices. Mold that causes aspergillosis is very common in homes. People can develop aspergillosis if a house is being demolished nearby.

However, for people with a normally functioning immune system, this mold is not a problem. The immune system recognizes the spores and destroys them.

However, people with a weakened immune system are at risk. In such cases, the spores can take hold and cause aspergillosis.

Aspergillosis is not transmissible from person to person.

The risk of infection depends on

• one’s own physical health and
• the extent of your exposure to the mold.

In general, the following risk factors increase the likelihood of developing aspergillosis:

A weakened immune system

This is the greatest risk factor for invasive aspergillosis. This includes

• people taking immunosuppressive medications, for example after surgery,
• cancer patients, or
• people with AIDS.

Low white blood cell count

White blood cells play an important role in fighting infections, including aspergillosis. A low white blood cell count makes the body more susceptible to invasive aspergillosis. People

• undergoing chemotherapy,
• organ transplants, or
• with leukemia.

Asthma or cystic fibrosis

Asthma and cystic fibrosis increase the risk of an allergic reaction to Aspergillus. As a result, people with these conditions are more likely to develop aspergillosis.

Ankylosing spondylitis

Ankylosing spondylitis is a very rare rheumatic lung disease that affects the spine. People with this disease—especially male smokers—are more likely to develop aspergillosis.

Long-term corticosteroid therapy

Long-term use of corticosteroids increases the risk of many infections, including aspergillosis.

Hospital stays

Aspergillus is more common in hospitals. Therefore, immunocompromised individuals are also at risk of contracting aspergillosis in this setting.

Depending on the type of aspergillosis, a number of serious complications can arise.

Aspergillosis in the sinuses can spread to the facial bones and destroy them. Aspergillosis can also spread beyond these bones and become life-threatening.

Both allergic aspergillosis and invasive aspergillosis can cause severe bleeding in the lungs.

The most serious complication of invasive aspergillosis is the spread of the infection to other parts of the body, such as

• the lungs,
• the brain, and
• other organs.

Invasive aspergillosis can spread very quickly if not treated promptly.

Most people who develop aspergillosis are already receiving treatment for other conditions. If new symptoms appear, contact your doctor immediately.

If you are seeing a new doctor, bring the necessary information about your medical history. This includes a list of the medications you are taking. Since a diagnosis of aspergillosis may result in admission to the emergency room, you should have someone accompany you to the doctor’s office.

Diagnosing aspergillosis can be difficult. Aspergillus is widespread, so traces of the fungus can even be found in the sputum and saliva of a healthy person.

Furthermore, it is difficult to distinguish Aspergillus from other fungi. In addition, the symptoms of aspergillosis resemble those of other diseases, such as tuberculosis.

Various diagnostic procedures can provide evidence of aspergillosis. These include the following methods:

X-rays or a CT scan can reveal mold deposits in the lungs.

A saliva test involves collecting a saliva sample. In the laboratory, any mold present can grow rapidly, allowing Aspergillus to be identified.

Diagnosing allergic aspergillosis usually requires tissue and blood tests. In a skin test, a small amount of Aspergillus antigen is injected into the skin. If the body has already produced antibodies against the mold, the skin at that site will react with redness.

A blood test looks for antibodies in the blood that indicate the presence of the mold.

During a biopsy, a small piece of tissue is removed from the affected area. This sample is examined under a microscope for traces of the mold.

Depending on the form of aspergillosis, simply monitoring the condition may be sufficient. In other cases, antifungal medication is used. Surgery is rarely necessary.

Monitoring Aspergillosis

Aspergillosis often does not require treatment. If there are no symptoms or only mild ones, it is not necessary to treat the fungus. This also prevents the patient from being exposed to potential side effects.

Instead, regular follow-up examinations are conducted. Doctors intervene only if the condition stabilizes or worsens.

Oral Corticosteroids for Aspergillosis

The goal of treating allergic aspergillosis is to prevent existing asthma or cystic fibrosis from worsening. Cortisone is the most effective treatment for this.

Antifungal medications alone do not resolve the infection, but they can be effective when used in combination with cortisone.

Antifungal medications

These medications are the standard treatment for invasive aspergillosis. In the past, amphotericin B was the primary treatment. Today, medications such as voriconazole are used more frequently because they are more effective and have fewer side effects.

Antifungal medications can still cause severe side effects. These occur particularly when taken in combination with other medications and in people with weakened immune systems.

Surgery for aspergillosis

Antifungal medications are not very effective against severe fungal infections in the lungs. Therefore, in severe cases, surgery is necessary, especially if bleeding in the lungs begins.

Since surgery carries risks, the doctor may first recommend embolization. In this procedure, a catheter is used to access the area of the lung where the fungal mass is located.

A special fluid is then administered to block the arteries and stop the bleeding.

This procedure is only a short-term solution for aspergillosis. It does not eliminate the mold.

It is nearly impossible to completely avoid Aspergillus. If you have risk factors for infection, try to avoid obvious sources of Aspergillus:

• mold,
• construction sites,
• compost piles, and
• stored grain.

Wearing a face mask can also help prevent infection with aspergillosis.