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Aspergillosis - Causes and Symptoms

Definition of Aspergillosis:

Aspergillosis refers to several forms of disease caused by a fungus of genus Aspergillus. The most common forms are allergic bronchopulmonary aspergillosis, pulmonary aspergilloma and invasive aspergillosis. In some individuals, the infection can even invade bone and the membranes that enclose the brain and spinal cord (meningitis). Compromised immune systems often allow Aspergillus to colonize. Aspergillosis is one of the most common fungal infection in birds caused by aspergella fumigates. Aspergillosis fungal infections mainly occur in the ear canal, eyes, nose, sinus cavities, and lungs.

Causes of Aspergillosis

Aspergillosis is caused by the inhalation of the spores of the Aspergillus fungus. Nosocomial infection may be associated with dust exposure during building renovation or construction. Occasional outbreaks of cutaneous infection traced to contaminated biomedical devices. Invasive aspergillosis rarely occurs in patients who are immunocompetent.

Aspergillus terreus, has emerged as a significant cause of aspergillosis and its incidence is growing. Aspergillus fungus can grow anywhere on dead leaves, stored grain, bird droppings, compost stacks and other decaying vegetation. Although most people are frequently exposed to aspergillus, infections caused by it such as a pneumonia or fungus ball ( aspergilloma ) are rare. A. terreus carries a much higher mortality rate than any of the more than 20 pathogenic Aspergillus species, with mortality 100% in many series. Some people, however, have an allergic reaction (hypersensitivity) to this fungus, which is called allergic bronchopulmonary aspergillosis (ABPA). ABPA is more commonly found in people with asthma and in people with cystic fibrosis.

Symptoms of Aspergillosis

Aspergillosis is mainly characterized by inflammation of the airways (bronchi) or air sacs (alveoli). The disease may mimic asthma or pneumonia, and, in fact, most patients with ABPA have asthma as well. Aspergillosis affecting the deeper tissues makes a person very ill. Some of the main symptoms of aspergillosis include:

  • Malaise.
  • Cough.
  • Delirium.
  • Shock.
  • Wheezing.
  • Recurrent episodes of lung obstruction.
  • Fever and Chills.
  • Shortness of breath.
  • Chest, facial or bone pain.
  • Loss of appetite.

In some serious cases,

  • There may be blood in the urine.
  • Weight loss may also occur.
  • Blood clots may also develop.
  • Cough, which may also be accompanied with blood or brownish mucous plugs.

In some people, there may be kidney failure, liver failure (causing jaundice), and breathing difficulties. Death can occur quickly.

Aspergillosis Diagnosis

Monitoring may include checking antibody levels and evaluating the airflow capacity of the lungs. People with asthma are generally advised to avoid their known triggers whenever possible. However, Aspergillus is a particularly common fungus. People with ABPA should try to stay away from marshes, forests, bogs, compost heaps and other areas where vegetation is known to be rotting.

Treatment for Aspergillosis

  • Invasive aspergillosis is treated with several weeks of intravenous amphotericin B, an antifungal medication. Itraconazole or voriconazole can also be used.
  • Endocarditis caused by Aspergillus is treated by surgical removal of the infected heart valves and long-term amphotericin B therapy.
  • Treatment of aspergilloma necessitates local excision of the lesion and supportive therapy, such as chest physiotherapy and coughing, to improve pulmonary function.
  • Allergic aspergillosis requires desensitization and, possibly, steroids.
  • Voriconazole: The preferred treatment for aspergillosis is voriconazole, a medication that is administered through an intravenous (IV) line for at least a week, followed by oral doses of the medication. But, it has some side effects also - like a rash is a common side effect.
  • Amphotericin B: Amphotericin B can be used as an alternative to voriconazole for the treatment of Aspergillosis. Liposomal formulations of amphotericin B - which attach the drug to microscopic spheres of fat - are a possibility (but are not officially approved for the treatment of aspergillosis), as they have been shown to be just as effective and somewhat less toxic than standard amphotericin B for the treatment of several types of fungal infections.

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