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Pulmonary aspergillosis
Pulmonary aspergillosis


Aspergillosis - chest X-ray
Aspergillosis - chest X-ray


Fungus
Fungus


Definition:

Pulmonary aspergillosis is an allergic reaction to a fungus called aspergillus, which causes inflammation of the airways and air sacs of the lungs.



Alternative Names:

Aspergillosis - allergic bronchopulmonary; Allergic bronchopulmonary aspergillosis; ABPA



Causes, incidence, and risk factors:

The aspergillus fungus is common. It can grow 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 are rare in people with a normal immune system. These rare infections include pneumonia and fungus ball (aspergilloma ).

Some people, however, have an allergic reaction (hypersensitivity) to this fungus, which is called allergic bronchopulmonary aspergillosis (ABPA). It is 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.

Patients with asthma or cystic fibrosis are at highest risk for allergic aspergillosis.



Symptoms:

Signs and tests:
  • Aspergillus antigen skin test
  • Bronchoscopy and transbronchial biopsy
  • CBC with peripheral eosinophil (a type of white blood cell) count
  • Chest x-ray
  • CT scan - chest
  • Lung biopsy (rare)
  • Serum aspergillus antibodies
  • Serum IgG and IgE antibodies
  • Sputum stain and culture for fungus


Treatment:

Allergic aspergillosis is treated with steroids such as prednisone. The antifungal antibiotic itraconazole can also be helpful. People with asthma should also continue their usual treatments.



Support Groups:



Expectations (prognosis):

People usually get better with treatment, over time. Relapses requiring repeat treatment are common.



Complications:

Calling your health care provider:

Call your health care provider if you have symptoms of this disorder.

Call your health care provider if breathing becomes more difficult. Severe breathing difficulty is an emergency.



Prevention:

People at higher risk (those with asthma, cystic fibrosis , etc.) should try to avoid environments where this fungus is found.



References: Walsh TJ, Anaissie EJ, Denning DW, et al. Treatment of aspergillosis: clincial practice guidelines of the Infectious Diseases Society of America. Clin Infect Dis. 2008;46(3):327-360.


Review Date: 5/19/2008
Reviewed By: Sean O. Stitham, MD, private practice in Internal Medicine, Seattle, WA; Jatin M. Vyas, MD, PhD, Instructor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Massachusetts General Hospital.. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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