Aspergillosis
Aspergillosis is an infection caused by fungi from the Aspergillus genus, primarily affecting the lungs but potentially spreading to other organs through the bloodstream. The condition can manifest in various forms, such as allergic bronchopulmonary aspergillosis, chronic necrotizing aspergillosis, and invasive aspergillosis, each presenting different symptoms based on the severity and the patient's immune status. Common symptoms include fever, cough, wheezing, and lung obstruction, with more severe cases showing chills, headaches, and complications affecting other organs.
Aspergillus spores are commonly found in soil and decaying organic matter, and infection is often associated with preexisting lung conditions or weakened immune systems. Treatment options vary depending on the type of aspergillosis; mild cases may require corticosteroids and antifungal medications, while more severe instances, especially invasive forms, necessitate immediate and aggressive antifungal therapy alongside possible surgical intervention. Understanding aspergillosis is crucial for early diagnosis and effective management, particularly for individuals with compromised health.
Aspergillosis
ANATOMY OR SYSTEM AFFECTED: Blood, bones, brain, ears, eyes, heart, kidneys, liver, lungs, spleen
DEFINITION: Infection with fungi from the genus Aspergillus, which initially produce pulmonary hypersensitivity reactions or colonize the lung and then either grow within a pulmonary cavity or disseminate through the blood to other organs.
CAUSES: Infection with Aspergillus fungal spores
SYMPTOMS: Fever, coughing, wheezing, lung obstruction, sinus infections; sometimes also chills, headaches, shortness of breath, chest pain, bone pain, blood in the urine, decreased urine output
DURATION: Acute
TREATMENTS: Oral corticosteroids, antifungal agents, surgical resection if needed
Causes and Symptoms
Members of the fungal Aspergillus are widely distributed in soil and decaying plant material. Inhalation of fungal spores can cause allergic reactions in people with asthma, a condition called allergic bronchopulmonary aspergillosis. In someone with a preexisting lung cavity caused by tuberculosis or cystic fibrosis, the fungus can grow within this cavity and form a fungus ball (aspergilloma) that moves within the cavity but does not invade the cavity wall. However, if the works poorly because of chronic steroid treatment, alcoholism, or underlying lung disease, then the fungus ball can invade the surrounding lung tissue, a condition called chronic necrotizing aspergillosis. If the immune system is profoundly weakened because of a recent organ transplant, advanced Acquired immunodeficiency syndrome (AIDS), or genetic diseases that cripple the immune system, then initial colonization of the lung with Aspergillus leads to dissemination of the through the bloodstream to other organs (invasive aspergillosis). This results in a rapidly progressing and often fatal infection.
Allergic reactions to Aspergillus or fungus balls usually cause fever, coughing that sometimes produces blood or brownish mucus, wheezing, recurrent episodes of lung obstruction, and sometimes sinus infections. The symptoms of invasive aspergillosis may additionally include chills, headaches, shortness of breath, chest pain, coughs that produce blood-filled material, bone pain, blood in the urine, decreased urine output, and symptoms involving specific organs, such as (brain), or visual impairment (eye), sinusitis, and (heart).
Treatment and Therapy
For to Aspergillus, oral corticosteroids are used, since inhaled steroids are typically ineffective. Addition of the antifungal drug itraconazole to might be necessary for patients whose allergies fail to resolve. Fungus balls are usually not treated unless they cause symptoms. Surgical resection of the affected part of the lung can cure fungus balls permanently, but only in people who have enough lung capacity to survive such a procedure. Invasive aspergillosis requires immediate therapy, and voriconazole is the usual first treatment choice. Amphotericin B is also a viable option, but its toxicity makes voriconazole the better choice. Caspofungin or posaconazole are also effective in those patients who do not tolerate or respond to other drugs. Fungus balls that invade the lung require prolonged treatment with voriconazole, itraconazole, or amphotericin B formulations to cure the patient completely, but surgical resection of the affected portion of the lung might be necessary.
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