Aspergillosis

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What is Aspergillosis?

Aspergillosis consists of a wide-spectrum of clinical pathology. It is an infection, a growth, or an allergic response caused by the Aspergillus fungus. Aspergillus are common in the soil and decaying vegetation. Colonisation of parts of the body by Aspergillus fungus is common.

However certain sites are involved more common than others, including:

lungs
sinuses
central nervous system
bones
eyes
heart
kidney
skin
ears
urinary tract, including bladder and urethra

Although the above listed may be involved, Aspergillus primarily affects the lungs. It causes 4 main syndromes, including allergic bronchopulmonary aspergillosis (ABPA), chronic necrotizing aspergillus pneumonia, aspergilloma, and invasive aspergillosis.

Who gets Aspergillosis?

Aspergillosis is common in the community. Depending on which type of aspergillosis, the figures vary. However it is fair to say that aspergillosis is common in the group of patients where their immune system is affected. This include those with HIV infection, and on medications that suppress immune system in transplant patients.

Other vulnerable groups include:

cancer patient undergoing chemotherapy.
intensive care unit patients on multiple antibiotics.

Predisposing Factors

Because of the abundance of aspergillus organisms in the environment, exposure to their spores is a frequent event. However, disease development due to fungi invasion occurs primarily in the state where there is reduced immunity. Any factors that lead to this will predispose the individuals to aspergillosis.

This includes:

Neutropenia(low white cell count that is important to fight infection)
corticosteroid use
HIV infection
allogenic stem cell transplant recipients
graft versus host disease
solid tumours

Progression

Aspergillosis occur in many organs in the body. With invasive aspergillosis, significant mortality ensues. However with other clinical diseases of aspergillosis, some will resolve spontaneously with suitable drugs, and some will go onto a chronic 'on and off' course of disease progression. Sometimes chronic aspergillus pneumonia (infection of the lung tissue by aspergillus fungi) can lead to severe complications such as diminished pulmonary function, and eventually death. The reason for this is the disease often remains undiagnosed and elusive.

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