Lung Condition: Aspergillosis

Aspergillosis is a condition that consists of infection or allergic reaction to various kinds of molds. Mold is a type of fungus that is often found outdoors on plants, soil, and decaying vegetation, though it can also grow indoors on dust, food items, and building materials. Aspergillus fumigatus is the mold that is most likely to cause aspergillosis in people when they inhale its spores.

There are three types of aspergillosis that you can contract. Pulmonary aspergillosis is most likely to develop in those who have chronic lung conditions or damaged lungs. This is because people with these conditions, such as emphysema or tuberculosis, are more likely to have abnormal spaces in their lungs where the fungus is able to grow.

Invasive aspergillosis is the most severe form of this condition, and it occurs when the infection travels from the lungs into the bloodstream. This can cause other organs, such as the kidneys, liver, skin, or brains, to become infected as well. This condition can be life threatening if not treated, and people with weakened immune systems are more susceptible to developing invasive aspergillosis.

Allergic bronchopulmonary aspergillosis (ABPA) is an allergic reaction that happens to some people after exposure to the aspergillus fungus. When this occurs, the fungus causes inflammation in the lungs and air passages. This form of aspergillosis often occurs in people who have been diagnosed with cystic fibrosis, bronchiectasis, or asthma due to the increased accumulation of mucus in their airways.

The typical cause of aspergillosis is the aforementioned form of mold known as aspergillus fumigatus. This mold is often found on dead leaves, compost piles, and other decaying vegetable matter, and even on grains, food, and spices. These mold spores can grow on air conditioning units and renovation sites, and can also be brought in on shoes and clothing and begin to grow on carpeting.

The intensity of the symptoms depends on which type of aspergillosis you have developed, although many of the symptoms are similar within each type. In the early stages of pulmonary aspergillosis, you may not experience any symptoms at all, but as the disease progresses, you may begin to experience wheezing, fever, chest pain, difficulty breathing, or coughing that brings up mucus or blood. The fibers of the fungus may also form into a lump by combining with white blood cells and blood clots, which is known as a fungus ball.

With invasive aspergillosis, symptoms may include fever, chills, shortness of breath, kidney or liver failure, bloody cough, internal bleeding in the lungs, and shock. Symptoms of allergic bronchopulmonary aspergillosis (ABPA) include wheezing or worsening of asthma, coughing that brings up mucus or blood, fever, increased mucus secretions, and decreased ability to perform physical activity.

Since this mold is commonly found in the environment, it is difficult to avoid exposure, which means that prevention methods may not be very efficient. Although this is the case, there are still steps you can take to decrease your risk of exposure, which include avoiding locations with large amounts of dust or mold, avoiding gardening and lawn mowing, and wearing a face mask to prevent exposure to airborne dust and mold. In some cases where exposure is highly likely, your doctor may recommend using antifungal medications to prevent infection.

To diagnose aspergillosis, your doctor will begin by asking about your medical history and symptoms. This condition can be difficult to determine due to the similarity of symptoms with other lung problems and infectious diseases, so your doctor will likely conduct a series of tests to be certain. These tests may include skin and blood tests, specifically when attempting to diagnose ABPA, imaging tests such as chest X-ray or CT scan, sputum sample, and biopsy.

Treatment options for aspergillosis consist of antifungal drugs, oral corticosteroid drugs, and in extreme cases, surgery. Antifungal drugs are mainly used for treatment of invasive or pulmonary aspergillosis, and these medications include voriconazole, amphotericin B, itraconazole, and caspofungin. Antifungals can sometimes cause serious side effects such as kidney or liver damage. Antifungal drugs can be used in combination with oral corticosteroid drugs when treating ABPA.

Oral medications, either in solid or liquid forms, may be prescribed to treat ABPA. These medicines reduce inflammation and prevent symptoms from getting worse. Commonly used oral corticosteroid drugs include prednisone, prednisolone, and methylprednisolone. Surgery may be required in cases where aspergillosis has caused fungus balls or internal bleeding, since medications are not very effective against fungus balls.