Aspergillosis: Symptoms, treatment, and when to seek help

Aspergillosis is a group of infections that occur due to inhaling spores of a fungus called Aspergillus. These infections are more likely to affect people with chronic lung disease or weakened immune systems.

Aspergillus species are prevalent, with the potential to live indoors and outdoors. The fungus may grow as mold in homes, especially in damp conditions with limited ventilation. Aspergillus can cause allergic reactions and infections in organs, including the lungs.

Aspergillosis can cause breathing problems and can sometimes lead to severe lung infections, which may lead to hospitalization in people with weakened immune systems, such as those with HIV, AIDS, or lung disease. However, most people who experience exposure to Aspergillus will not develop aspergillosis.

Read on to learn more about aspergillosis.

A type of fungus called Aspergillus can cause an allergic response or infection in some people. Doctors refer to this as aspergillosis.

Aspergillosis develops when a person inhales the spores of Aspergillus fungus into their lungs, and the fungus grows there. This may happen if the body's immune system cannot fight infection.

Most people can inhale Aspergillus spores without getting sick. However, people with lung disease or weakened immune systems may be more likely to experience aspergillosis. For some, it is potentially dangerous.

Several types of the condition exist. Invasive aspergillosis, where the fungus spreads from the lungs to the bloodstream, can be life threatening without treatment.

Most types of aspergillosis cause a cough and shortness of breath, except allergic Aspergillus sinusitis.

However, the severity of these symptoms varies with the kind of aspergillosis, and certain forms cause additional symptoms.

Some additional symptoms based on the type of aspergillosis include:

Allergic aspergillosis

Allergic aspergillosis, which doctors may also call allergic bronchopulmonary aspergillosis, causes lung inflammation similar to an allergic reaction.

Occasionally, aspergillosis can cause allergic sinusitis, which causes symptoms only in the sinuses. A person might have congestion or a stuffy nose.

People are more likely to develop allergic aspergillosis if they have asthma or cystic fibrosis.

Invasive aspergillosis

Invasive aspergillosis is a severe infection of the lungs. It can also spread to other areas of the body, such as the brain or bloodstream. Some types of invasive aspergillosis are resistant to first-line fungal treatments.

The condition tends to be more common in people with a weakened immune system, such as those with HIV or AIDS. Invasive aspergillosis can be fatal without treatment.

Aspergilloma

An aspergilloma is a fungus ball that can form in the lungs during an aspergillosis infection. While it may affect breathing, aspergilloma is less likely to spread to other areas of the body.

Chronic aspergillosis

Chronic aspergillosis is less severe but occurs when Aspergillus causes infection in the lung cavities. Symptoms can last 3 months or longer and commonly cause aspergillomas.

Other types of aspergillosis

Some less common forms of the condition include:

Cutaneous aspergillosis

Cutaneous aspergillosis can occur when spores of Aspergillus fungus enter the body through a wound or other break in the skin. It can also develop when invasive aspergillosis spreads to the skin.

Azole-resistant aspergillosis

Azole-resistant aspergillosis is a form of the infection that is resistant to azoles, a class of antifungal drugs. Aspergillus fumigatus is typically the causative agent. Treating azole-resistant aspergillosis can be challenging.

When a person inhales the spores of the Aspergillus fungus, and the body cannot fight off infection, the fungus can grow in the lungs.

This is more likely to occur in people with certain conditions, including:

It is also more likely among the following groups:

organ transplant recipients
people taking medications that weaken the immune system
people in the hospital with severe flu

Aspergillosis can be challenging to diagnose.

This is because no diagnostic tool is 100% accurate. Some tests, such as lab cultures of tissue samples from the lungs, can sometimes miss the infection.

A doctor may make the diagnosis based on information about a person's history, risk factors, and test results. Some tests a doctor may recommend include:

imaging scans of the lungs to look for a nodules
bloodwork to test for signs of infection and rule out other conditions
other blood tests, including galactomannan and Aspergillus polymerase chain reaction tests, which can help detect Aspergillus infection in people with weakened immune systems, such as organ transplant recipients
a lung biopsy, which is the only way to confirm the diagnosis

Antifungal medications can treat aspergillosis.

Some drugs a doctor might prescribe include:

itraconazole (Onmel, Sporanox)
voriconazole (Vfend)
amphotericin B (AmBisome)
posaconazole (Noxafil)
caspofungin (Cancidas)

Depending on their symptoms and other risk factors, a person may need to take antifungal drugs for a period of a few days up to several months.

As these medications tend to cause serious side effects, doctors typically only prescribe them after a lung biopsy shows a person has aspergillosis.

Supportive care, usually in a hospital setting, may be necessary when someone has a severe infection that is affecting their ability to breathe. For example, people with underlying chronic lung diseases may need additional treatment to manage their condition and reduce their risk of developing another infection.

A doctor may also recommend surgery in cases where a person develops aspergilloma.

Learn more about antifungal medications.

In some cases, certain forms of aspergillosis can be fatal.

Invasive aspergillosis

The invasive form of the infection has a near 100% fatality rate without treatment.

Some other complications of invasive aspergillosis include:

Chronic or allergic aspergillosis

Chronic or allergic aspergillosis can cause:

A person should seek medical help for new or worsening breathing symptoms if they have a chronic lung disease or a weakened immune system.

People without these conditions should seek help in the following situations:

if they have significant trouble breathing
if cold or allergy symptoms do not resolve
if they have new breathing difficulties that do not improve within a few days
if they have signs of an infection, such as a fever and trouble breathing
if they feel very sick after exposure to soil, dust, or mold

It is not always possible to prevent aspergillosis because this fungus is widespread.

However, some strategies that can reduce the risk of an infection include:

reducing exposure to mold by removing moisture and improving ventilation in the home
wearing a mask when exposure to soil and dust is not preventable
treating chronic lung diseases
talking with a doctor about preventive treatment with antifungal drugs

Aspergillosis primarily afflicts people with chronic medical conditions or lung disease. These are also risk factors for severe complications and additional medical issues with the infection. Managing chronic health conditions and seeking immediate care for any new or worsening symptoms of infection is important.

Without treatment, invasive aspergillosis can be fatal. Even milder forms of the infection can significantly undermine well-being, so it is important that people with symptoms seek prompt care.

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