Aspergillosis is an infection, allergic reaction, or fungal growth caused by the Aspergillus fungus. The fungus usually grows on decaying vegetation and dead leaves. Exposure to the fungus doesn’t necessarily guarantee that you’ll get aspergillosis. Almost everyone encounters the fungus on a daily basis and never contracts the illness. It’s more likely to infect people with a weak immune system or a lung disease.
There are several types of aspergillosis.
• Pulmonary aspergillosis
It is most likely to develop in people who have chronic lung disorders or damaged lungs. These people are likely to have abnormal spaces in their lungs where the fungus can grow. The fungus can also rarely infect sinuses and ear canals. The mold spores can colonize (grow) inside lung cavities that developed as a result of chronic diseases, such tuberculosis, emphysema, or advanced sarcoidosis. The fibers of fungus might form a lump by combining with white blood cells and blood clots. This lump or ball of fungus is called an aspergilloma or mycetoma. In some cases, a fungus ball may be present in other organs of the body.
• Invasive aspergillosis
It is the most severe type, occurs when the infection travels from the lungs into the bloodstream. Other organs, such as the kidneys, liver, skin or brain, may become infected. This is a very serious condition that may result in death if not treated. People with very weakened immune systems are more susceptible to invasive aspergillosis.
• Allergic bronchopulmonary aspergillosis (ABPA)
It is an allergic reaction that happens to some people after exposure to Aspergillus fungus. The fungus causes inflammation in the lungs and air passages. ABPA is more common in people with cystic fibrosis, bronchiectasis and/or asthma because they tend to have more mucus in their airways.
The signs and symptoms of aspergillosis vary with the type of illness you develop:
▪︎ Allergic reaction
Some people with asthma or cystic fibrosis have an allergic reaction to aspergillus mold. Signs and symptoms of this condition, known as allergic bronchopulmonary aspergillosis, include:
• A cough that may bring up blood or plugs of mucus
• Worsening asthma
Certain chronic lung (pulmonary) conditions, such as emphysema, tuberculosis or advanced sarcoidosis, can cause air spaces (cavities) to form in the lungs. When people with lung cavities are also infected with aspergillus, fungus fibers may find their way into the cavities and grow into tangled masses (fungus balls) known as aspergillomas.
Aspergillomas may produce no symptoms or cause only a mild cough at first. Over time and without treatment, however, aspergillomas can worsen the underlying chronic lung condition and possibly cause:
• A cough that often brings up blood (hemoptysis)
• Shortness of breath
• Unintentional weight loss
▪︎ Invasive aspergillosis
This is the most severe form of aspergillosis. It occurs when the infection spreads rapidly from the lungs to the brain, heart, kidneys or skin. Invasive aspergillosis occurs only in people whose immune systems are weakened as a result of cancer chemotherapy, bone marrow transplantation or a disease of the immune system. Untreated, this form of aspergillosis may be fatal.
Signs and symptoms depend on which organs are affected, but in general, invasive aspergillosis can cause:
• Fever and chills
• A cough that brings up blood (hemoptysis)
• Shortness of breath
• Chest or joint pain
• Headaches or eye symptoms
• Skin lesions
▪︎ Other types of aspergillosis
Aspergillus can invade areas of your body other than your lungs, such as your sinuses. In your sinuses, the fungus can cause a stuffy nose sometimes accompanied by drainage that may contain blood.
• Facial pain
• Headache may also occur.
In most cases, aspergillosis is caused by a type of mold called Aspergillus fumigatus.
• Aspergillus mold can often be found on dead leaves, compost piles and other decaying vegetable matter, stored grain, and even foods and spices. • The mold spores may be carried indoors on shoes and clothing and can grow on carpeting.
• Window unit air conditioners are susceptible to mold growth if filters are not kept clean, and water does not drain properly from the unit.
• Sites where buildings are being torn down or renovated may be contaminated with mold spores.
Aspergillosis is not contagious from person to person.
Risk Factors –
Your risk of developing aspergillosis depends on your overall health and the extent of your exposure to mold. In general, these factors make you more vulnerable to infection:
• Weakened immune system.
People taking immune-suppressing drugs after undergoing transplant surgery — especially bone marrow or stem cell transplants — or people who have certain cancers of the blood are at highest risk of invasive aspergillosis. People in the later stages of AIDS also may be at increased risk.
• Low white blood cell level.
People who have had chemotherapy, an organ transplant or leukemia have lower white cell levels, making them more susceptible to invasive aspergillosis. So does having chronic granulomatous disease — an inherited disorder that affects immune system cells.
• Lung cavities.
People who have air spaces (cavities) in their lungs are at higher risk of developing aspergillomas.
• Asthma or cystic fibrosis.
People with asthma and cystic fibrosis, especially those whose lung problems are long-standing or hard to control, are more likely to have an allergic response to aspergillus mold.
• Long-term corticosteroid therapy.
Long-term use of corticosteroids may increase the risk of opportunistic infections, depending on the underlying disease being treated and what other drugs are being used.
• Amphotericin B can cause kidney damage and unpleasant side effects such as fever and chills
• Bronchiectasis (permanent scarring and enlargement of the small sacs in the lungs)
• Invasive lung disease can cause massive bleeding from the lung
• Mucus plugs in the airways
• Permanent airway blockage
• Respiratory failure
The health care provider will perform a physical examination and ask about the symptoms.
Tests to diagnose aspergillus infection include:
• Aspergillus antibody test
• Chest x-ray
• Complete blood count
• CT scan
• Galactomannan (a sugar molecule from the fungus that is sometimes found in the blood)
• Immunoglobulin E (IgE) blood level
• Lung function tests
• Sputum stain and culture for fungus (looking for aspergillus)
• Tissue biopsy
Aspergillosis treatments vary with the type of disease. Possible treatments include:
Simple, single aspergillomas often don’t need treatment, and medications aren’t usually effective in treating these fungal masses. Instead, aspergillomas that don’t cause symptoms may simply be closely monitored by chest X-ray. If the condition progresses, then antifungal medications may be recommended.
• Oral corticosteroids.
The goal in treating allergic bronchopulmonary aspergillosis is to prevent existing asthma or cystic fibrosis from worsening. The best way to do this is with oral corticosteroids. Antifungal medications by themselves aren’t helpful for allergic bronchopulmonary aspergillosis, but they may be combined with corticosteroids to reduce the dose of steroids and improve lung function.
• Antifungal medications.
These drugs are the standard treatment for invasive pulmonary aspergillosis. The most effective treatment is a newer antifungal drug, voriconazole (Vfend). Amphotericin B is another option.
All antifungal drugs can have serious side effects, including kidney and liver damage.
Because antifungal medications don’t penetrate an aspergilloma very well, surgery to remove the fungal mass is the first-choice treatment when an aspergilloma causes bleeding in the lungs.
This procedure stops lung bleeding caused by an aspergilloma. This treatment works temporarily, but the bleeding is likely to start again.
Ayurvedic Perspective –
There is no connection has been told in Ayurvedic texts with disease like Aspergillosis, but it can be correlated with Kasa and Shwasa Roga having severe symptoms with all the three doshas involved.
Some beneficial herbs –
• Ashwagandha(Indian ginseng)
• Vasa(Malabar nut)
Some Ayurvedic Formulations –
• Gandhak Rasayan
• Kaishore Guggulu
• Arogyavardhini Vati
• Chandraprabha Vati
It’s nearly impossible to avoid exposure to aspergillus, but if you have had a transplant or are undergoing chemotherapy, try to stay away from places where you’re likely to encounter mold, such as construction sites, compost piles and buildings that store grain.
If you have a weakened immune system, your doctor may advise you to wear a face mask to avoid being exposed to aspergillus and other airborne infectious agents.
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