Aspergillosis – Symptoms and Causes
Overview
Aspergillosis infections require different approaches based on severity and type. For mild cases, doctors might recommend careful monitoring without immediate intervention. Most infections need antifungal medications to control the fungal growth.
Common treatments include:
- Oral medications for less severe cases
- Intravenous antifungals for serious infections
- Inhaled medications for certain respiratory forms
In rare situations where the infection causes significant damage or forms fungal balls (aspergillomas), surgical intervention may be necessary. Patients with allergic bronchopulmonary aspergillosis often need both antifungals and medications to reduce inflammation.
Treatment duration varies widely—from weeks to months—depending on the infection type and the patient’s immune status. Regular follow-up appointments help doctors adjust treatments as needed for optimal recovery.
Signs and Warning Signs
People with asthma or cystic fibrosis may develop an allergic reaction to aspergillus mold, known as allergic bronchopulmonary aspergillosis. This condition has several noticeable signs.
Common symptoms include:
- Fever
- Coughing that may produce blood or mucus plugs
- Worsening of existing asthma symptoms
People with chronic lung conditions like emphysema, tuberculosis, or advanced sarcoidosis can develop air spaces in their lungs. When aspergillus infects these cavities, it can grow into tangled masses called fungal balls or aspergillomas.
Early on, fungal balls might cause no symptoms or just a mild cough. Without treatment, they can worsen the underlying lung condition and lead to:
Progressive symptoms:
- Coughing up blood (hemoptysis)
- Wheezing sounds when breathing
- Difficulty breathing
- Weight loss without trying
- Ongoing tiredness
The most dangerous form happens when the infection spreads quickly from the lungs to other organs like the brain, heart, kidneys, or skin.
This severe form only affects people with weakened immune systems from cancer treatment, bone marrow transplants, or immune disorders.
Warning signs vary by affected organ but may include:
- Fever with chills
- Bloody cough
- Breathing difficulties
- Pain in the chest or joints
- Headaches or vision problems
- Skin sores or lesions
Without treatment, this form can be deadly.
The fungus can affect areas beyond the lungs, such as the sinuses. When sinuses become infected, symptoms may include:
- Stuffy nose
- Nasal drainage (sometimes containing blood)
- Fever
- Pain in the face
- Headaches
When to See a Doctor
Contact your doctor if you have asthma or cystic fibrosis and notice any changes in your breathing. While these changes might not always be caused by aspergillosis, all breathing problems need medical evaluation.
If you have a weakened immune system, seek immediate medical attention if you experience:
- Unexplained fever
- Shortness of breath
- Coughing up blood
Important: For invasive aspergillosis, quick treatment is essential. Doctors may start antifungal medication as soon as they suspect aspergillosis, even before test results confirm it. Early treatment can make a significant difference in recovery.
Causes
Aspergillus mold exists everywhere in our environment. It grows in fallen leaves, plant matter, compost piles, and various crops.
Most people with normal immune systems face no problems when exposed to this mold. The body’s defense cells quickly surround and eliminate inhaled spores.
People become vulnerable to aspergillosis when their immune system is weakened by:
- Certain illnesses
- Medications that suppress immune function
In these cases, the body has fewer defensive cells available to fight the mold. This allows Aspergillus to establish itself in the lungs and sometimes spread to other body areas in severe cases.
Aspergillosis cannot spread from person to person.
Risk Factors
Your chance of getting aspergillosis depends on how healthy you are and how much mold you’re exposed to. Several factors can make you more likely to develop this infection:
Weakened Immune System
- People who take immune-suppressing medications after transplant surgery
- Individuals with certain blood cancers
- Those in advanced stages of AIDS
Low White Blood Cell Count
- Patients who have undergone chemotherapy
- People who’ve had organ transplants
- Individuals with leukemia
- Those with chronic granulomatous disease (an inherited immune disorder)
Lung Cavities
People with air spaces in their lungs have a higher risk of developing aspergillomas (fungal balls).
Respiratory Conditions
If you have asthma or cystic fibrosis, especially when these conditions are long-lasting or difficult to control, you’re more likely to have allergic reactions to aspergillus mold.
Corticosteroid Treatment
Using corticosteroid medications for a long time can increase your risk of opportunistic infections like aspergillosis. The risk varies based on your underlying condition and other medications you take.
Complications
Aspergillosis infections can lead to several serious health problems:
Lung Bleeding: Both aspergillomas and invasive aspergillosis may cause severe bleeding in the lungs, which can be life-threatening.
-
Spread to Other Organs: Invasive aspergillosis can quickly spread beyond the initial infection site to other body parts, including the:
- Brain
- Heart
- Kidneys
This systemic spread happens rapidly and often has fatal outcomes if not treated promptly. People with weakened immune systems face the highest risk of these complications.
Prevention
Avoiding aspergillus exposure completely is challenging, but certain precautions can reduce risk.
People with weakened immune systems from transplants or chemotherapy should avoid mold-heavy environments. These include construction sites, compost piles, and grain storage facilities.
Immunocompromised individuals may benefit from wearing face masks in public settings to reduce exposure to aspergillus and other airborne pathogens.
Always follow your doctor’s specific recommendations about protective measures based on your medical condition and treatment status.
