Aspergillosis is infection, usually of the lungs, caused by the fungus Aspergillus.
Aspergilli are very common and frequently occur in compost heaps, air vents, and airborne dust. Inhalation of Aspergillus spores is the primary cause of aspergillosis. Aspergillosis has several forms:
A fungus ball in the lungs may cause no symptoms and may be discovered only when a chest x-ray is taken for other reasons. Or it may cause repeated coughing up of blood and, rarely, severe, even fatal bleeding. A rapidly invasive infection in the lungs often causes cough, fever, chest pain, and difficulty breathing. Without treatment, this form of invasive aspergillosis is fatal.
Aspergillosis that spreads to other organs makes people very ill. Symptoms include fever, chills, shock, delirium, and blood clots. Kidney failure, liver failure (causing jaundice), and breathing difficulties may develop. Death can occur quickly.
Aspergillosis of the ear canal causes itching and occasionally pain. Fluid draining overnight from the ear may leave a stain on the pillow. Aspergillosis of the sinuses causes a feeling of congestion and sometimes pain or discharge.
Doctors suspect the diagnosis based on symptoms. An x-ray or computed tomography (CT) of the infected area also provides clues for making the diagnosis.
Whenever possible, doctors send a sample of infected material to a laboratory to grow (culture), examine, and confirm identification of the fungus. A viewing tube (bronchoscope or rhinoscope) may be used to obtain this material from the lungs or sinuses.
Aspergillosis that affects only a sinus or a single area in the lung requires treatment but does not pose an immediate danger because it progresses slowly. However, if the infection is widespread or if people appear seriously ill, treatment is started immediately.
Invasive aspergillosis is treated with antifungal drugs, such as amphotericin B or voriconazole. However, some forms of Aspergillus do not respond to these drugs and may need to be treated with caspofungin, a newer antifungal drug, with or without the other drugs.
Doctors treat aspergillosis in the ear canal by scraping out the fungus and applying drops of antifungal drugs. Collections of fungi in the sinuses must usually be removed surgically. If fungus balls in the lungs grow near large blood vessels, they may also need to be removed surgically because they may invade the blood vessel and cause bleeding.
Last full review/revision October 2008 by Alan M. Sugar, MD