Aspergillosis
Aspergillosis is the name of a group of fungal conditions caused by a mould called aspergillus.
It usually affects the respiratory system (windpipe, sinuses and lungs) and causes wheezing and coughing, but it can spread to anywhere in the body.
Aspergillosis can usually be treated with medication, but in a few cases it’s very serious and potentially life-threatening.
How do you get aspergillosis?
You can get aspergillosis if you inhale tiny particles of the aspergillus mould that hang in the air.
The mould is found in many different places, but it’s particularly common in:
rotting leaves and compost
plants, trees and crops
air conditioning and heating systems
insulation material
dust
In most people, inhaling aspergillus particles isn’t a problem, because your immune system quickly destroys them. However, aspergillosis can develop if you have a pre-existing lung condition, such as asthma or cystic fibrosis, or if you have a weakened immune system.
Aspergillosis isn’t contagious, so it can’t be passed from person to person.
Read more about the causes of aspergillosis.
Symptoms of aspergillosis
The symptoms of aspergillosis vary.
General symptoms can include:
a persistent cough
coughing up mucus or coughing up blood
fatigue
weight loss
a high temperature
Contact your doctor if you develop severe or persistent symptoms of aspergillosis, particularly if you have a weak immune system. There are several tests that can lead to a diagnosis.
Read more about the symptoms of aspergillosis and diagnosing aspergillosis.
Types of aspergillosis
The main types of aspergillosis that affect the lungs are:
allergic bronchopulmonary aspergillosis
chronic pulmonary aspergillosis
invasive pulmonary aspergillosis
Aspergillus mould can also sometimes infect other parts of the body, including the skin, eyes, sinuses and other internal organs, mainly in people with a weak immune system.
Allergic bronchopulmonary aspergillosis
Allergic bronchopulmonary aspergillosis (ABPA) is caused by an allergy to inhaled aspergillus particles and typically causes wheezing, shortness of breath, a cough with mucus and sometimes blood. It’s caused by the immune system reacting to the aspergillus mould.
ABPA usually affects people with asthma or cystic fibrosis. It’s estimated that around 1 in every 40 people with asthma may be affected by ABPA.
There’s also a very similar condition called severe asthma with fungal sensitisation (SAFS).
Chronic pulmonary aspergillosis
Chronic pulmonary aspergillosis (CPA) is a long-term infection that usually only affects people with an underlying lung condition, such as tuberculosis (TB), chronic obstructive pulmonary disorder (COPD) or sarcoidosis. Along with a persistent cough, breathlessness, tiredness and weight loss, coughing up blood is a common symptom.
CPA can sometimes cause an aspergilloma (a fungal ball) to grow in the lungs. It can also result in the lungs becoming permanently scarred if it isn’t treated.
It’s estimated that around 400-750 people in England have CPA.
CPA requires specialist follow up treatment with antifungal medications and is usually long-term. The National Aspergillosis Centre offers specialist follow up of patients with CPA.
Invasive pulmonary aspergillosis
Invasive pulmonary aspergillosis (IPA) usually only affects people with a weak immune system, such as people who have received a bone marrow transplant or cancer treatment, or those with HIV or AIDS. It’s the most serious type of aspergillosis.
If you have IPA, it’s likely you’ll have a raised temperature as well as lung symptoms, such as a cough, chest pain or breathlessness.
In IPA, the aspergillus mould can spread through the bloodstream from the lungs to the brain, eyes, heart or kidneys. This is very serious and can be life-threatening if it’s not treated quickly.
IPA is estimated to affect up to one in every four people who’ve had a bone marrow transplant, a heart or lung transplant, or high-dose chemotherapy for leukaemia (cancer of the blood cells).
Treatments for aspergillosis
Treatment for aspergillosis depends on the specific type.
ABPA and SAFS are usually treated with steroid medication to dampen the reaction of the immune system to the aspergillus particles, and antifungal medication to help kill the mould.
CPA and aspergilloma can be treated with long-term antifungal medication. In some cases, surgery may be needed to remove an aspergilloma from the lungs, prevent bleeding in the lungs, or remove infected tissue.
IPA is treated in hospital with powerful antifungal medications given by a drip into a vein. The infection can spread very quickly, and people who develop IPA are usually already very ill. This means that, unfortunately, around half of those with the condition die from it.
Read more about how aspergillosis is treated.
Preventing aspergillosis
It’s almost impossible to avoid the aspergillus mould completely, but there are precautions you can take to reduce your exposure if you’re at risk of aspergillosis.
Try to avoid places where the mould is often found, such as:
compost heaps
grain stores
rotting vegetation
piles of dead leaves
marshland and bogs
forests
If you have a weakened immune system, you may also be advised to take extra precautions, such as wearing a face mask and taking a long-term course of antifungal medication.
Read more about preventing aspergillosis.