Aspergillosis: what it is, types, symptoms and treatment

Aspergillosis is an infectious disease caused by the fungus Aspergillus fumigatus , which is present in several environments, such as soil, pantas, decomposing and construction material, for example. In this way, people are in frequent contact with the fungus, but not all develop the disease.

Aspergillosis occurs more frequently in people who have an immune system compromised by diseases, such as HIV and lupus, for example, or due to organ transplants or the use of medications that decrease the activity of the immune system, such as corticosteroids, chemotherapy or immunosuppressants.

The main route of infection for Aspergillus is through inhalation, allowing it to stay in the lungs and lead to symptoms such as cough, shortness of breath and fever, which can quickly worsen and affect other parts of the body, such as the brain, heart or kidneys, especially when antifungal treatment is not started.

Main symptoms

After inhaling the spores of Aspergillus fumigatus , the fungus can colonize the respiratory tract and remain in the body without symptoms. However, in people with a compromised immune system, symptoms may appear according to the affected site and severity of the infection, and there may be:

1. Allergic reaction

It occurs mainly in people with a history of chronic lung diseases, such as asthma or cystic fibrosis and includes signs such as:

• Fever above 38ºC; Coughing up blood or phlegm; Feeling of shortness of breath; Runny nose and difficulty smelling.

This is the least serious type of reaction and, in most cases, it can even be treated with drugs that were already being used for asthma attacks, for example. However, if your symptoms are getting worse it is very important to go to the hospital.

2. Pulmonary aspergillosis

These cases are also very common, but usually affect people who have no history of lung disease. Symptoms include:

• Weight loss; Persistent cough; Coughing up blood; Excessive tiredness; Feeling of shortness of breath.

If not properly treated, the lung infection can develop and spread through the blood, reaching other parts of the body.

3. Invasive aspergillosis

It is the most serious type of infection that occurs when the fungus can multiply in the lungs and then spread through the blood. The signs of this type of aspergillosis can be:

• Fever above 38º C; Chest pain; Persistent cough; Joint pain; Headache; Swelling of the face.

In addition, this fungus has the ability to enter blood vessels, spread more easily and promote vessel closure, resulting in thrombosis.

Invasive aspergillosis is the most common type when the immune system is very weak and, therefore, its symptoms can be difficult to identify, since they can be interpreted as symptoms of the disease that this is based on the decrease of the body's defenses.

How the diagnosis is made

The diagnosis of aspergillosis can be made through the culture of the infected tissue, observation of the sputum through the microscope or blood test with serology that detects specific antibodies against this fungus.

What is the treatment

Treatment for aspergillosis usually starts with taking antifungal drugs, such as Itraconazole or Amphotericin B, which help to eliminate excess fungi from the body, helping the immune system to control infection and relieve symptoms.

However, the doctor may also advise the use of corticosteroids, such as Budesonide or Prednisone, to relieve symptoms more quickly and improve the effect of the antifungal, especially in people with very intense symptoms, as in those with asthma, for example.

In the most serious cases, of invasive aspergillosis, in which a mass of fungi may develop, the doctor may advise surgery to remove the most affected tissues and facilitate the effect of antifungals.