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Aspergillosis

Aspergillosis

Aspergillosis is a form of mould infection, caused by a fungus. Aspergillosis-related infections often impact the respiratory system, but symptoms and severity can vary widely.

Aspergillus, the mould that causes the infections, is present both inside and outdoors. The majority of these mould strains are not harmful, but a few of them can be harmful to those individuals which are compromised with immune systems, underlying lung conditions, or asthma when they inhale the fungus spores.

The spores might cause an allergic response in certain persons. Others get minor to severe lung infections. When the infection spreads to blood vessels and beyond, it results in invasive aspergillosis, the most dangerous type of condition.

Treatment options for aspergillosis might range from monitoring to antifungal drugs to, in extreme circumstances, surgery.

 

Types of Aspergillosis:

Aspergillosis can take many different forms: 

  1. Pulmonary Aspergillosis: People with damaged or chronic lung conditions are more prone to acquire pulmonary aspergillosis than healthy individuals. These folks most likely have aberrant lung areas in which the fungus can flourish.
  1. Invasive Aspergillosis: The most serious condition of aspergillosis, invasive aspergillosis, is when the infection spreads from the lungs into the bloodstream. Infections can spread to other organs including the kidneys, liver, skin, or brain.

 

  1. Allergic bronchopulmonary aspergillosis (ABPA): Some patients experience an allergic reaction known as allergic bronchopulmonary aspergillosis (ABPA) after being exposed to the Aspergillus fungus. The fungus causes inflammation that has an impact on the lungs and airways. People with cystic fibrosis, bronchiectasis, and/or asthma are much more prone to suffer ABPA because they tend to have more mucus in their airways.

Histology of aspergillosis: 

The inflammatory pattern in fungal forms of aspergillosis is determined by the depth of invasion and the patient's immune status. Sometimes fungal balls form, which are made up of numerous organisms that form a mass, sometimes with fruiting heads. A dense acute infiltrate in the dermis and deep soft tissue is more common, and it may be associated with necrosis and scarring. Close examination with routine H-E staining may occasionally reveal the organisms. The morphology is better appreciated with special stains, which show thin, septate hyphae with regular branching.  Angioinvasion, ulceration, and extensive necrosis are possible. A dense granulomatous response is common in immune-competent patients. Direct skin inoculation can result in a significant epidermal response.

 

Causes and risks:

Aspergillus fumigatus is a species of mould that typically causes Aspergillosis. Dead leaves, compost piles, decomposing vegetable matter, stored grains, as well as foods and spices, are frequent places where Aspergillus mould can be discovered. The mould spores can develop on carpets and be brought inside on shoes and clothing. If filters are not kept clean and water does not drain from the unit correctly, window air conditioning units are vulnerable to mould development. Building demolition and renovation sites could include mould spore contamination.

A very uncommon fungal infection is aspergillosis. Undiagnosed, mild instances are possible. Medical research indicates that aspergillosis is becoming more common. There have been cases of aspergillosis documented everywhere.

Symptoms: 

The severity of the symptoms might vary depending on the kind of aspergillosis.

In its early stages, pulmonary aspergillosis may not manifest any symptoms. Symptoms that might appear as the illness worsens include:

  • Coughing, occasionally with blood or mucous
  • Wheezing
  • Fever
  • Chest pain
  • Trouble breathing

 

Invasive aspergillosis symptoms might include:

  • Fever
  • Chills
  • Breathing problems
  • Liver or kidney failure
  • Shock
  • Significant pulmonary hemorrhage or bloody cough.

 

Aspergillosis bronchopulmonary allergy may result in:

  • The presence of blood or mucous when coughing
  • Wheezing or an asthma attack
  • Fever
  • Increased sputum or mucus production
  • Activity-induced asthma or an inability to tolerate exercise

 

Diagnosis:

When diagnosing aspergillosis, medical professionals take into account your medical history, risk factors, symptoms, physical examinations, and lab testing. Depending on where the infection is, you might require imaging tests like a chest x-ray or a CT scan of your lungs or other regions of your body. Your healthcare professional may take a sample of fluid from your respiratory system to send to a lab if they have reason to believe that you have an Aspergillus infection in your lungs. Doctors may also do a tissue biopsy, in which a tiny sample of the afflicted tissue is examined under a microscope or in a fungal culture in a lab to check for Aspergillus contamination. An early diagnosis of invasive aspergillosis in those with highly compromised immune systems can be made with the aid of a blood test.

 

Treatment:

 

  1. Medication: All sorts of illnesses are treated with antifungal medications. The invasive form of aspergillosis can be treated with oral or injectable medications such as voriconazole. If you suffer from allergic aspergillosis, your doctor may prescribe antifungal medications together with immune system suppressants like prednisone.

 

  1. Surgery: The diseased regions of your heart valves must often be removed surgically if the fungus is the source of the infection. You will receive intensive antifungal care following the operation. Remember that aspergillosis is not a contagious disease.

Conclusion:

Aspergillosis is an infection caused by mould (fungus). The illnesses caused by aspergillosis usually affect the respiratory system, but their symptoms and severity vary greatly. Aspergillus mould, which causes the illnesses, is found indoors and outdoors.

Dr. Tanay Joshi
Respiratory & Sleep Medicine
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