This document discusses Aspergillosis, a fungal infection caused by Aspergillus mold. It can cause different types of infections depending on the immune status of the infected person, ranging from mild to very serious invasive infections. Diagnosis involves culture, antigen testing, imaging and biopsy. Treatment depends on the type of infection but may include antifungal medications. Those at highest risk are those with weakened immune systems.

2.  It is a disease caused by common mold,
Aspergilllus.
 Aspergillus species is a type of fungus found
indoors and outdoors. Aspergillus fumigatus
is the most common cause of human
Aspergillus infections . Other species such
as Aspergillus flavus, A. terreus, A.niger,
A.nidulans and A.versicolor are also known
to cause infections in humans.

3. Aspergillus fumatigus in
Lactophenol cotton Blue dye.
 Most people breathe
Aspergillus spores everyday
without getting sick. However
people with weakened
immune system or lung
disease are at higher risk of
developing health problems
due to Aspergillus .
 There are different types of
Aspergillosis some are mild
while some are very serious.

5.  Allergic bronchopulmonary aspergillosis
(ABPA): Aspergillus cause inflammation in
lungs and allergy symptoms such as
coughing and wheezing but doesn’t cause
an infection.
 Allergic aspergillus sinusitis: Aspergillus
causes inflammation in the sinuses and
shows symptoms of sinus infection(
drainage, stiffness &headache) but doesn’t
cause an infection.

6.  Aspergilloma : It is also called as Fungal ball
as its name suggests it is a ball of
Aspergillus that grows in the lungs or
sinuses but usually doesn’t spread to other
parts of the body.
 Chronic pulmonary aspergillosis: A long term
( 3months or more) condition in which
Aspergillus can cause cavities in the lungs.
One or more fungal ball (Aspergilloma) may
be present in lungs.

7.  Invasive aspergillosis : A serious infection that
usually affect people who have weakened
immune system , such as people who have had
an organ transplant or s stem cell transplant.
Invasive aspergillosis most commonly affects
lungs but it can also spread to other parts of the
body.
 Cutaneous aspergillosis : Aspergillus enter the
body through ruptured skin ( surgery or burn
wound) and causes infection usually in people
who have weakened immune system .
Cutaneous aspergillosis can also occur if
invasive aspergillosis spreads to the skin from
somewhere else in the body such as lungs.

10. A definitive diagnosis of Aspergillosis typically
requires a positive culture from normally
sterile site and histopathological evidence of
infection. Other diagnostic tools include
radiology, galactomannan antigen, Beta D-
glucan detection and PCR.
 Notable symptoms
 Physical examination
 Lab tests.

11.  Allergic bronchopulmonary aspergillus
(ABPA) :
 Wheezing
 Shortness of breath
 Cough
 Fever( rare cases)
 Allergic aspergillus sinusitis:
 Stiffness
 Runny nose
 Headache
 Reduced ability to smell

12.  Aspergilloma :
 Cough
 Coughing up blood
 Shortness of breath
 Chronic Pulmonary aspergillosis :
 Weight loss
 Cough
 Coughing up blood
 Fatigue
 Shortness of breath

13.  Invasive Aspergillosis :
It can be difficult to now which symptoms are
related to aspergillosis since usually occurs in
people who are already sick from other medical
conditions. However symptoms of invasive
aspergillosis in lung include :
 Fever
 Chest pain
 Cough
 Coughing up blood
 Shortness of breath
 Other symptoms can develop if infection spreads
from lungs to other parts of body

14.  X- ray or C T scan of lungs or other parts of
body depending on location of infection.
 Microscopy : Sample of fluid from respiratory
system to be examined for septated hyphae
with acute angle branching.
 Histopathological Examination : a tissue biopsy
of affected tissue has to be analyzed under
microscope or in a fungal culture.

15.  Culture : Aspergillus sp. grows in 1-3 days after
incubation. It allows identification up to species
level. But is Insensitive in patients with invasive
aspergillosis.
 Galactomannan antigen test :detects
polysaccharide that makes up part of the cell wall
Aspergillus sp. and other fungi. Platelia Assay
approved by FDA for serum and bronchoalveolar
lavage fluid. False positive tests are reported in
association with certain antibiotics and cross
reactivity with other fungal infections as Fusarium
sp. or Histoplasma capsulatum

16.  Beta – d –glucan Assay : It also detects a
component of the cell wall of Aspergillus sp.
The Fungitell Assay has been approved by
FDA for diagnosis of invasive fungal
infections. It has reduced a variety of clinical
settings including exposure to certain
antibiotics, hemodialysis and co- infection
with certain bacteria.
 Polymerase Chain reaction (PCR) : fro
detection of Aspergillus sp. From specimens
, including fluid from bronchoalveolar lavage
and tissue.

17.  For ABPA or Allergic aspergillus sinusitis
Itraconazole prescription of antifungal
medication
 For Invasive aspergillosis voriconazole is
prescribed. Immunosupresssive medication
should be discontinued or reduced.
 Alternative treatment include lipid amphotericin
formulation, Posaconazole, Isavuconazole,
Caspofungain and Micafungin.

18.  Prophylaxis against Aspergillosis is
recommended during prolonged neutropenia
for patients who have high risk of
Aspergillosis, allogeneic stem cell transplant
with graft versus host disease, lung
transplant recipients and certain other solid
organ transplant recipients under certain
conditions.

19.  ABPA occurs mostly in people who have Cystic
fibrosis or Asthma.
 Aspergilloma affect people who have other lung
diseases like Tuberculosis.
 Chronic pulmonary aspergillosis typically occurs in
people who have other lung diseases including
tuberculosis, Chronic obstructive pulmonary
disease COPD or Sarcoidosis.
 Invasive aspergillosis affects people who have
weakened immune systems, such as who have had
a stem cell transplant or organ transplant , or
chemotherapy for cancer or taking high doses of
corticosteroids.

20. It is difficult to avoid breathing Aspergillus sp.
spores because the fungus in common in the
environment. But for people who have
weakened Immune systems there may be some
ways to lower chances of developing severe
infection.
 Avoid areas with lot of dust.
 Avoid activities involving close contact with soil/
dust
 To reduce chances of skin infection , clean skin
injuries well with soap and water, especially if
they have been exposed to soil or dust.

21.  Barnes PD, Marr KA. Aspergillosis: spectrum of disease, diagnosis,
and treatment. Infect Dis Clin North Am. 2006 Sep;20(3):545-61, vi.
 Agarwal R, Chakrabarti A, Shah A, Gupta D, Meis JF, Guleria R, et al.
Allergic bronchopulmonary aspergillosis: review of literature and
proposal of new diagnostic and classification criteria. Clin Exp Allergy.
2013 Aug;43(8):850-73.
 Glass D, Amedee RG. Allergic fungal rhinosinusitis: a review. Ochsner
J. 2011 Fall;11(3):271-5.
 Lee SH, Lee BJ, Jung DY, Kim JH, Sohn DS, Shin JW, et al. Clinical
manifestations and treatment outcomes of pulmonary aspergilloma.
Korean J Intern Med. 2004 Mar;19(1):38-42.
 Denning DW, Riniotis K, Dobrashian R, Sambatakou H. Chronic
cavitary and fibrosing pulmonary and pleural aspergillosis: case series,
proposed nomenclature change, and review. Clin Infect Dis. 2003 Oct
1;37 Suppl 3:S265-80.
 Van Burik JA, Colven R, Spach DH. Cutaneous aspergillosis. J Clin
Microbiol. 1998 Nov;36(11):3115-21.

22.  Schweer KE, Bangard C, Hekmat K, Cornely OA. Chronic pulmonary
aspergillosis. Mycoses. 2014 May;57(5):257-70.
 Avery RK, Michaels MG. Strategies for safe living after solid organ
transplantation. Am J Transplant. 2013 Mar;13 Suppl 4:304-10.
 CDC. Guidelines for preventing opportunistic infections among
hematopoietic stem cell transplant recipients. MMWR. 2000
Oct;49(RR-10):1-125, CE1-7.
 Brizendine KD, Vishin S, Baddley JW. Antifungal prophylaxis in solid
organ transplant recipients. Expert Rev Anti Infect Ther. 2011
May;9(5):571-81.
 Rogers TR, Slavin MA, Donnelly JP. Antifungal prophylaxis during
treatment for haematological malignancies: are we there yet? Br J
Haemato. 2011 Jun;153(6):681-97.
 Maertens J, Van Eldere J, Verhaegen J, Verbeken E, Verschakelen J,
Boogaerts M. Use of circulating galactomannan screening for early
diagnosis of invasive aspergillosis in allogeneic stem cell transplant
recipients. J Infect Dis. 2002 Nov 1;186(9):1297-306.
 Lackner M1, Lass-Flörl C. Up-date on diagnostic strategies of invasive
aspergillosis. Curr Pharm Design 2013;19(20):3595-614.
 Weber DJ et al. Preventing healthcare-
associated Aspergillus infections: a review of recent CDC/HICPAC
recommendations. Med Mycol 2009; 47S1: S199-209.