Aspergillosis is an infection by the fungus Aspergillus. Aspergillosis describes a large number of diseases involving both infection and growth of fungus as well as allergic responses. Aspergillosis can occur in a variety of organs, both in humans and animals.
All animals and many plants have highly efficient mechanisms to prevent themselves being infected by Aspergillus, and it is usually only when those mechanisms are defective in some way that Aspergillus can grow within the body.
Further information for patients on types of aspergillosis can be found in the patient’s section of this site.
The vast majority of people who may develop aspergillosis are those that have had their immune system weakened – possibly after transplant surgery or following treatments for cancer.
Alternatively aspergillosis can occur in an immunocompetent person (i.e. a person with no known suppression of their immune system) where previous tissue damage has occurred – for instance heavily scarred pulmonary tissue associated with tuberculosis, chronic obstructive pulmonary disease or bronchiectasis or some underlying lung disease. Comprehensive overview.
Invasive aspergillosis normally only occurs in severely immune-compromised patients and has a high mortality rate (25-90%). Invasive disease is most commonly seen in the lungs, which is called pulmonary aspergillosis, but although less common, dissemination of aspergillus to other tissues, including the central nervous system, sinuses, bone, heart, kidney, eye, blood and skin, has been reported.
Risk factors for invasive aspergillosis include patients on steroids, chemotherapy treatment resulting in severe neutropenia, stem cell and solid organ transplantation, later stages of AIDS, and a genetic disease called chronic granulomatous disease.
Diagnosis can be made by detection of aspergillus species by biopsy, culture and microscopy of tissue samples. Chest CT scans and detection of aspergillus antigens in body fluids, by a variety of methods, all assist with diagnosis but do not give a definitive diagnosis of invasive aspergillosis.
Treatment is with antifungal drugs such as voriconazole, caspofungin, itraconazole, posaconazole, or amphotericin B. Voriconazole is usually more effective than amphotericin B; serum levels of voriconazole and itraconazole must be monitored and individually adjusted. There are many other drug interactions known for both itraconazole and voriconazole which must be considered. For comprehensive information on the diagnosis, treatment and prevention of aspergillosis and information on antifungal drugs and patient information leaflets visit the Patient Support section.
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