Aspergillosis, A Common Fungal Infection
By Cesar Collado
Aspergillosis causes illness on a variety of levels. First, it is an allergen triggering allergic responses. Second, it might colonize and simply reproduce in specific areas or cavities in the human body, especially sinuses and lungs leading to infection. Third, Aspergillus is a pathogen and can cause a life-threatening infection and a dangerous immune response. Finally, it produces secondary metabolites called mycotoxins that are toxic and can cause organ failure and neurological problems. An aspergillus infection can lead to the body quickly reaching its “Toxic Load” where a patient becomes sensitive to almost any chemical, biochemical, or smell.
Aspergillus is a fungi genus consisting of several hundred species found in various climates. Approximately 60 species are known be relevant pathogens resulting in various human illnesses. You will find Aspergillus species almost everywhere in the environment, such as on plants, trees, soil, and decaying vegetation. Aspergillus is commonly identified on moldy foods, especially starches such as bread. It is also a common indoor mold due to its proclivity to grow on drywall when exposed to moisture, commonly used in most residential and commercial settings.
Most people breathe in Aspergillus daily without getting sick. However, people with a weakened immune system or respiratory diseases will be at higher risk of pathogenic aspergillosis.
Types of Aspergillus Fungal Infections:
Aspergillosis manifests in several different forms, each affecting different parts of the body:
- Allergic Bronchopulmonary Aspergillosis (ABPA) causes inflammation in the lungs that will result in coughing and wheezing. ABPA most commonly impacts individuals with asthma or cystic fibrosis.
- Chronic Pulmonary Aspergillosis (CPA) impacts people with pre-existing lung conditions, like chronic obstructive pulmonary disease (COPD) or tuberculosis. As a result, Invasive Pulmonary Aspergillosis (IPA), the most severe form, often affects immunocompromised patients, such as transplant recipients or individuals with HIV/AIDS.
- Aspergillomas: A “fungal ball” of aspergillus that can reproduce and colonize in the lungs or sinuses. The fungi can cause inflammation, mucous production, and headaches.
- Invasive Aspergillosis: A serious fungal infection can occur in in people with compromised immune systems such as organ or stem cell transplant patients. The infection commonly affects the lungs but can spread to other parts of the body.
- Mycotoxicosis: Several mycotoxins are secondary metabolites produced by Aspergillus species. The most potent toxins are aflatoxins, ochratoxins, gliotoxin, fumonisins, sterigmatocystin, and patulin. Mycotoxicosis occurs when either eaten or released by a fungal presence in the body. Severe symptoms can result from the following cellular activity:
- Potent carcinogenic activity and acute toxicity to various human cells such as lymphocytes, monocytes, granulocytes, hepatocytes, renal cells, lung epithelial cells
- Immuno-suppressive activities
- Suppression of the function of macrophages
- Direct access to the brain due to inhalation and penetration through the blood-brain barrier
Read more about the challenges of diagnosing mycotoxin poisoning in the Toxic Mold Mystery article.
Aspergillosis Fungal Infection Symptoms and Risk Factors
The symptoms of aspergillosis will vary depending on the form of the infection. ABPA can cause wheezing, coughing, and increased mucus production, while CPA might lead to weight loss, fatigue, and persistent chest pain. IPA, being the most severe form, can result in fever, severe cough, and shortness of breath, and if left untreated, it can lead to a life-threatening condition. Common risk factors include use of immunosuppressive medications, chemotherapy, organ transplantation, and prolonged use of corticosteroids.
Fungal Infection Diagnostic Methods
Diagnosing aspergillosis involves a combination of clinical assessment, imaging studies, and laboratory tests. Chest X-rays or CT scans can help identify lung abnormalities associated with the infection. A sputum culture or bronchoscopy may be performed to collect respiratory samples for fungal identification. Blood tests can detect specific antibodies and antigens associated with Aspergillus. Accurate and timely diagnosis is crucial to ensure appropriate treatment. Urine testing is available but is not approved by the FDA. Unfortunately, urine testing is often inconclusive.
Fungal Infection Treatment Options
The treatment approach for aspergillosis depends on the type and severity of the infection, as well as the patient’s overall health. Antifungal medications, such as voriconazole and itraconazole, are commonly prescribed to combat the fungal growth. For ABPA, corticosteroids might be used to reduce inflammation and manage allergic responses. In severe cases of IPA, a combination of anti-fungal drugs and surgical intervention to remove infected tissue might be necessary. Amphotericin B is the most potent anti-fungal that may be used in a hospital setting. Extreme caution must be taken with its use due to hepatotoxicity.
Preventive Measures for Fungal Infection
Preventing aspergillosis involves taking precautions, especially for high-risk individuals. Hospital environments should maintain strict infection control measures to minimize the risk of fungal exposure. Individuals with weakened immune systems or lung conditions should avoid environments with high mold exposure and take prescribed medications as directed. Proper hygiene, such as washing hands frequently and washing clothing with an antimicrobial laundry detergent can also reduce the risk of fungal infections.
Aspergillosis is a serious fungal infection that affects individuals with compromised immune systems and underlying lung conditions. Understanding the different forms of the infection, recognizing the symptoms, and seeking early diagnosis are crucial steps in managing and treating aspergillosis effectively. With appropriate medical care and preventive measures, the impact of aspergillosis on public health can be minimized, and those at risk can be better protected.