Aspergillosis

Aspergillosis is an infection or allergic reaction caused by aspergillus — a mold (fungus) found in the environment, such as in decaying vegetation and household dust. In healthy individuals, it rarely causes problems. But aspergillus may affect people with asthma or weakened immune systems.

An aspergillus skin test can determine whether someone has been exposed to aspergillus. It's performed by injecting an aspergillus antigen under the skin. Inflammation at the injection site indicates past exposure to aspergillus.

Aspergillus can cause illness in several ways, including:

• An allergic reaction (allergic bronchopulmonary aspergillosis, or ABPA) in people with asthma
• A serious infection (invasive pulmonary aspergillosis) in people with weakened immune systems, such as organ transplant recipients and those receiving chemotherapy

ABPA is an allergic lung reaction that often mimics pneumonia. Signs and symptoms include:

• Fever
• Malaise
• Cough
• Wheezing
• Coughing up blood or characteristic mucous plugs
• Worsening of asthma

A doctor may make a diagnosis of ABPA by:

• A computerized tomography (CT) scan of the lungs
• Examination of a mucous plug under a microscope, which shows the aspergillus organisms
• A blood serology test

Treatment may include oral prednisone.

Signs and symptoms of invasive pulmonary aspergillosis include:

• Fever
• Chills
• Headaches
• Cough
• Shortness of breath
• Chest pain
• Joint pain

The infection can spread to other organs, such as the skin, eyes, heart, brain and kidneys. Diagnosis and treatment are difficult. A doctor may suspect invasive pulmonary aspergillosis based on a chest X-ray or CT scan or by a sputum stain and culture. A diagnosis may be confirmed by a biopsy of infected tissue. Treatment usually includes antifungal medications.