What is Aspergillosis?
Aspergillosis is an infection, allergic reaction, or fungal growth that is caused by Aspergillus fungus. The fungus thrives on dead leaves and decomposing vegetation. You don't have to be exposed to the fungus to have aspergillosis. Almost everyone comes into contact with the fungus on a regular basis but never becomes sick. People with a weakened immune system are more likely to become infected. Aspergillus, the mold that causes the infections, may be found both indoor and outdoor. When persons with compromised immune systems, underlying lung disease, or asthma inhale their fungal spores, the majority of types of this mold are innocuous, but a few might cause catastrophic infections.
The spores can cause an allergic reaction in certain persons. Invasive aspergillosis is the most dangerous type of aspergillosis, which occurs when the infection spreads to blood vessels and beyond. Observation, antifungal drugs, or, in rare situations, surgery may be used to treat aspergillosis, depending on the kind of aspergillosis.
While cases of mucormycosis, often known as Black Fungus, have been on the rise, COVID-19 positive patients and those who have recovered from the virus have been shown to have another invasive fungal infection, Nasal Aspergillosis. According to reports, the rise in fungal infections is due to the uncontrolled use of steroids for COVID-19 treatments, as well as the use of non-sterile water to hydrate the oxygen supply.
Infection with pulmonary aspergillosis has been found in persons with weakened immune systems. Though sinus pulmonary aspergillosis, which is currently being seen in COVID patients, is uncommon. Experts believe that though aspergillosis is not as severe as the black fungus infection, it can still be fatal.
Who’s at Risk?
The usage of steroids and reduced immunity are being blamed for the rise in instances of different fungal infections among COVID-19 patients. It is also believed that non-sterile water used to hydrate the oxygen supply is to blame for its prevalence. One of the main causes of the growth in black fungus infections is the inappropriate use of steroids in the treatment of COVID-19. As a result, doctors are being cautioned to use steroids with extreme caution and to avoid overdoing it.
Types of Aspergillosis
Varied forms of aspergillosis have different effects on the body. You're more likely to develop each type if you have certain medical conditions or take certain medications. Aspergillosis manifests itself in a variety of ways.
Allergic Bronchopulmonary Aspergillosis
The fungus causes allergic bronchopulmonary aspergillosis (ABPA), which causes coughing and wheezing. If you have a lung condition like cystic fibrosis or asthma, you're more likely to contract this type of aspergillosis. Shortness of breath and a general sense of being sick are also symptoms of ABPA.
If your immune system has been damaged by chemotherapy or illnesses like leukemia, cancer, or AIDS, you're more likely to get an invasive form of aspergillosis. Infections are more difficult to resist when the immune system is weakened. This type of aspergillosis attacks the tissues of your lungs and can extend to your kidneys or brain. Invasive aspergillosis can lead to infectious pneumonia if left untreated. In patients with weakened immune systems, infectious pneumonia can be fatal.
Exposure to the fungus can trigger fungus growth if you have tuberculosis or another lung condition. This form of development, also known as a fungus ball, is made up of fungus, clots, and white blood cells. Typically, the growth does not migrate to other parts of your body. The ball, on the other hand, can get larger and cause damage to your lung tissues.
Causes of Aspergillosis
Mold caused by Aspergillus niger is unavoidable. It can be found in decaying leaves and compost, as well as on plants, trees, and grain crops, outside. For those with healthy immune systems, daily exposure to aspergillus is rarely a concern. Inhaled mold spores are surrounded and destroyed by immune system cells. People with a weaker immune system due to disease or immunosuppressive medicines, on the other hand, have fewer infection-fighting cells. Aspergillus can then take hold, infiltrating the lungs and, in the worst-case scenario, other sections of the body. It is not spread from one person to another.
The doctor will discuss your symptoms with you and go through your medical history to see if you have any problems that render you vulnerable to the sickness. A biopsy is typically used to obtain and test lung tissue for invasive aspergillosis. Your doctor may also use a tool to access your lungs and collect a little sample of fluid for fungal testing through your mouth or nose.
The tests will include:
- Blood Tests to check for the antibodies and fungus molecules
- Chest X-Ray
- CT Scan of the lungs
- Sputum stain and culture for examining the bronchial mucus
Symptoms of Aspergillosis
When the infection has moved fast from the lungs to the brain, sinuses, heart, kidneys, or skin, it is known as aspergillosis. People who have weakened immune systems due to COVID-19, cancer chemotherapy, bone marrow transplantation, or an immune system disorder. Aspergillosis can be lethal if left untreated.
Signs and Symptoms of Aspergillosis
- Fever and chills
- Cough which brings up blood
- Shortness of breath
- Chest or joint pain
- Headache and eye symptoms
Treatment of Aspergillosis
Treatments for aspergillosis differ depending on the type of infection. Treatment options include:
Simple, solitary aspergillomas don't always require treatment, and drugs aren't always helpful in removing these fungi. Instead, aspergillomas that aren't causing symptoms can be checked with a chest X-ray. Antifungal drugs may be prescribed if the illness worsens.
The method of therapy for allergic bronchopulmonary aspergillosis is to keep asthma and cystic fibrosis from getting worse. Oral corticosteroids are the most effective approach to achieve this. Antifungal drugs aren't effective on their own for allergic bronchopulmonary aspergillosis, but they can be used in conjunction with corticosteroids to lower the dose of steroids and improve lung capacity.
Invasive pulmonary aspergillosis is treated with these medications. Voriconazole, a newer antifungal medicine, is the most successful treatment (Vfend). Another alternative is amphotericin B. All antifungal medications have the potential to cause major side effects, such as kidney and liver damage. Antifungal drug interactions with other treatments are also common.
This technique stops aspergilloma-related lung hemorrhage. A radiologist uses a catheter to inject a substance into an artery feeding a lung cavity where an aspergilloma is causing blood loss due to an aspergilloma. The injected material solidifies, cutting off the area's blood supply and halting the bleeding. This treatment works for a while, but the bleeding will most likely return.
As antifungal drugs have a hard time penetrating an aspergilloma, surgery to remove the fungal mass is the first line of defense when an aspergilloma causes pulmonary hemorrhage.
Treatment usually heals allergic aspergillosis. If you're exposed to the fungus on a regular basis, you can acquire it again. Recovery from invasive aspergillosis is dependent on your general health and immune system strength. Aspergilloma is a fungal infection that usually does not require treatment.