February 1, 2017

Aspergillosis is a spectrum of fungal diseases that frequently affects the lungs. It is caused by the fungus Aspergillus. Aspergillus is a mold, commonly present in the environment; the spores invade blood vessels, causing hemorrhagic necrosis and infarction. Mold is often found outdoors on plants, soil, or rotting vegetable matter. Mold can also grow indoors on household dust, food items such as ground spices, and building materials.

Aspergillosis can be fatal, especially to those with immunodeficiency. Collectively, this group of diseases is referred to as aspergillosis and is broadly broken down into three categories – allergic, chronic and invasive. Four main clinical types of aspergillosis are usually identified – allergic bronchopulmonary aspergillosis, aspergilloma, invasive aspergillosis, and chronic necrotizing aspergillosis. Aspergillosis rarely develops in healthy individuals; it is much more likely to develop in individuals with asthma, cystic fibrosis, diabetes mellitus, and lung disease or in individuals who have a weakened immune system, who take corticosteroid drugs or who have had a bone marrow or organ transplant. In most cases, aspergillosis develops when susceptible individuals breathe in (inhale) Aspergillus spores.


  • Allergic Bronchopulmonary Aspergillosis (ABPA) – In ABPA, the fungus causes allergic reactions such as coughing and wheezing.
  • Invasive Aspergillosis – People are more likely to experience an invasive type of aspergillosis if the immune system has been weakened by leukemia, cancer, AIDS, chemotherapy, or other conditions that make it difficult to fight infections. This type invades the lung tissues and can spread to the kidneys or brain.
  • Aspergilloma – If a person has tuberculosis or another lung disease, being exposed to the fungus can cause to develop a fungus growth. Also called a fungus ball, this type of growth usually consists of fungus, clots, and white blood cells. The growth does not typically spread to other areas of your body.

Aspergillus species can cause severe disease in children whose immune systems are weakened. The lungs are often involved, as are the sinuses and ear canals. This is a serious infection (invasive aspergillosis) that often destroys the lungs and can result in death.


In most healthy people, the immune system is able to quickly destroy the mould before it causes any problems. However, symptoms can develop in people with a pre-existing lung condition or a weak immune system. Aspergillosis isn’t contagious, so it can’t be passed from person to person.

Aspergillus mould can be found in –

  • Rotting leaves and compost
  • Plants, trees and crops
  • Air conditioning and heating systems
  • Insulation material
  • Carpets
  • Pillows and bedding
  • Dust
  • Ground pepper and spices

Risk Factors

  • Allergic bronchopulmonary aspergillosis (ABPA) most often occurs in people who have cystic fibrosis or asthma.
  • Aspergillomas usually affect people who have other lung diseases like tuberculosis.
  • Chronic pulmonary aspergillosis typically occurs in people who have other lung diseases, including tuberculosis, chronic obstructive pulmonary disease (COPD), or sarcoidosis.2
  • Invasive aspergillosis affects people who have weakened immune systems, such as people who have had a stem cell transplant or organ transplant, are getting chemotherapy for cancer, or are taking high doses of corticosteroids.


Symptoms can range from mild to severe, depending on the type of aspergillosis.

Pulmonary aspergillosis might not cause any symptoms, especially in the early stages. If the disease progresses, symptoms may include –

  • Coughing, sometimes accompanied by mucus or blood
  • Wheezing
  • Fever
  • Chest pain
  • Difficulty breathing

Symptoms of invasive aspergillosis may include –

  • Fever
  • Chills
  • Breathing difficulties, such as shortness of breath
  • Kidney or liver failure
  • Shock
  • Bloody cough or massive bleeding from the lungs

Allergic bronchopulmonary aspergillosis may cause –

  • Coughing accompanied by mucus or blood
  • Wheezing or worsening of asthma
  • Fever
  • Increased mucus or sputum secretions
  • Inability to tolerate exercise or asthma brought on by exercise


  • Oral corticosteroid drugs—Solid or liquid oral medications may be prescribed to treat allergic bronchopulmonary aspergillosis. These drugs reduce inflammation and prevent respiratory symptoms, such as wheezing and coughing, from getting worse. Some of the most commonly used drugs are prednisone, prednisolone, and methylprednisolone.
  • Antifungal drugs—These medications are generally used to treat invasive pulmonary aspergillosis. Voriconazole is currently the drug of choice because it causes fewer side effects and appears to be more effective than other medications. Amphotericin B or itraconazole are also effective in treating infection. Caspofungin is sometimes used in cases where the infection is resistant to the other antifungals.
  • Antifungal drugs are sometimes used along with oral corticosteroids when treating ABPA. Antifungals can cause serious side effects, such as kidney and liver damage.
  • Surgery—Surgery may be necessary in cases when aspergillomas are present and cause serious problems, such as excessive bleeding. Antifungal medications are usually not effective against aspergillomas, so surgery is recommended. Embolization may be an option to block blood flow to the artery supplying blood to the lung cavity where the fungus ball is located. This will stop the bleeding, but it may recur later.

Alternative Treatment

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