Aspergillosis – what is Aspergillosis?

Aspergillosis is a condition caused by aspergillus

Aspergillosis is a condition caused by aspergillus

 

Aspergillosis is a condition caused by aspergillus mould. There are several different types of aspergillosis – most affect the lungs and cause breathing difficulties.

How you get aspergillosis

Aspergillosis is usually caused by inhaling tiny bits of mould. The mould is found in lots of places, including:

soil, compost and rotting leaves

plants, trees and crops

dust

damp buildings

air conditioning systems

You can’t catch aspergillosis from someone else or from animals.

Most people who breathe in the mould don’t get ill.

Aspergillosis is rare in healthy people

You’re usually only at risk of aspergillosis if you have:

a lung condition – such as asthma, cystic fibrosis or chronic obstructive pulmonary disease (COPD)

a weakened immune system – for example, if you’ve had an organ transplant or are having chemotherapy

had tuberculosis (TB) in the past


Symptoms of aspergillosis

Symptoms of aspergillosis include:

shortness of breath

a cough – you may cough up blood or lumps of mucus

wheezing (a whistling sound when breathing)

a high temperature of 38C or above

weight loss

If you already have a lung condition, your existing symptoms may get worse.

See a GP if you have:

a cough for more than 3 weeks

a lung condition that’s getting worse or harder to control with your usual treatment

a weakened immune system and symptoms of aspergillosis

Get an urgent GP appointment if you cough up blood. Call 111 if you can’t see your GP.

What happens at your appointment

Your GP will check for an obvious cause of your symptoms, like a chest infection or asthma.

If they’re not sure what the problem is, they may refer you to a specialist for tests such as:

X-rays and scans

blood tests or tests on a sample of mucus

allergy tests

a bronchoscopy – where a thin, flexible tube with a camera at the end is used to look in your lungs

Treatment for aspergillosis depends on the type

Treatment usually helps control the symptoms. If it isn’t treated or well controlled, there’s a risk it could damage your lungs.

Common types Treatment
Allergic bronchopulmonary aspergillosis (ABPA) – an allergy to aspergillus mould steroid tablets and antifungal tablets for a few months (possibly longer)
Chronic pulmonary aspergillosis (CPA) – a long-term lung infection long-term (possibly lifelong) treatment with antifungal tablets
Aspergilloma – a ball of mould in the lungs, often linked to CPA surgery to remove the ball if it’s causing symptoms
Invasive pulmonary aspergillus (IPA) – a life-threatening infection in people with a weakened immune system antifungal medicine given directly into a vein in hospital

You can’t always prevent aspergillosis

It’s almost impossible to completely avoid aspergillus mould.

But there are things you can do to reduce your risk of aspergillosis if you have a lung condition or weakened immune system.

Do

try to avoid places where aspergillus mould is often found, such as compost heaps and piles of dead leaves

close your windows if there’s construction work or digging outside

wear a face mask in dusty places

consider using an air purifier at home – devices with HEPA filters are best

What is Aspergillosis?

Aspergillosis

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:

shortness of breath

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.