What Is Aspergillus Fumigatus?
Aspergillus fumigatus is a fungus that causes diseases in humans. If your immune system is weakened by disease or medication, this fungus can make you very sick. Aspergillus fumigatus is everywhere — it exists all around you — in soil, air, and other organic matter. But if you have a healthy immune system, it can deal with it properly. The fungus can multiply and cause diseases if your immune system is not functioning properly.
If you have a healthy immune system, this fungus doesn't grow or cause diseases. Aspergillus fumigatus is considered an opportunistic organism. It has low virulence (ability to cause damage) and causes disease only in some circumstances, such as:
- A severely weakened state caused by sickness, poor nutrition, advanced age, etc.
- Immunosuppression by diseases or medicines
- Use of implants, such as prosthetic devices
Aspergillosis is an infection caused by this fungus. The spores grow into hyphae (the active form of the fungus) that cause diseases by tissue invasion, colonization, and allergic reactions. Your immune system cells can destroy the hyphae but not the spores.
Some conditions such as chronic granulomatous disease, prolonged neutropenia, inherited immunodeficiencies, and acquired immunodeficiency syndrome (AIDS) , put you at risk of getting sick. Aspergillus fumigatus infections in such situations are dangerous and often fatal.
Aspergillus Fumigatus Disorders
The fungus spores (called conidia) enter your body in the air you breathe. They first reach the nose, throat, sinuses, and lungs. Aspergillus fumigatus causes disease by invading your tissues, preventing immune cell function, forming blood clots (thrombosis), and stimulating allergic reactions.
In people with poor immunity, the infection may spread all over the body, including the brain and other organs. Aspergillus fumigatus symptoms depend on the part of the body infected and your own immunity. Some disorders caused by this fungus are:
Chronic pulmonary aspergillosis (CPA). This is a condition in which the fungus grows slowly in the lungs, causing damage from inflammation and scarring, and symptoms may only show after months or years. The common symptom is coughing. Other symptoms are weight loss, tiredness, and breathlessness. If the growing fungus damages a blood vessel, you may cough up blood (hemoptysis). Coughing up blood is a serious symptom, and you should go to a hospital immediately.
Invasive aspergillosis. It's a life-threatening condition and happens to people who are severely immunocompromised (have a weak immune system). The fungus grows rapidly, and the lungs are affected most often. Invasive aspergillosis may involve the sinuses, ears, skin, or eyes. The symptoms depend on the organ affected by the condition.
Aspergillomas. These are round fungal balls created by the growth of the fungus in a lung cavity. These often don't cause symptoms until they damage a blood vessel, causing you to cough up blood. Other forms of lung infections caused by Aspergillus fumigatus are aspergillus nodules and chronic fibrosing pulmonary aspergillosis. They often cause no symptoms or only nonspecific ones such as cough, tiredness, and weight loss.
Fungal sinusitis.Aspergillus fumigatus spores often reach the sinuses and multiply there. They can cause symptoms by tissue invasion and provoking allergic reactions. Symptoms are similar to those of other types of sinusitis , including nasal stuffiness, difficulty breathing, facial pain, headaches, thick green or dark nasal discharge, and mucus along the back of the throat.
Aspergillus species are not dermatophytes (fungi that cause skin disease) and don't often infect the skin. But Aspergillus fumigatus can sometimes cause onychomycosis, an infection of the nails.
Aspergillus Fumigatus Allergy
Aspergillus fumigatus infections are dangerous and often lead to death. The fungus can also cause allergic conditions, such as allergic bronchopulmonary aspergillosis (ABPA) and allergic sinusitis. These cause sickness and symptoms but are rarely fatal.
You're likely to have ABPA if you already have a lung condition such as cystic fibrosis, bronchiectasis, or asthma. This condition is an allergic reaction to inhaled spores of Aspergillus fumigatus. Spores not quickly removed by the immune system swell and release toxins. These toxins trigger an inflammatory reaction that causes asthma-like symptoms, such as wheezing, cough, and breathlessness. You are also at risk of getting an Aspergillus fumigatus infection if you have a weakened immune system or have recently had the flu or COVID-19, particularly if you used a breathing machine.
Aspergillus symptoms
Most healthy people aren't bothered by aspergillus mold. If you think you may have been exposed, you might have the following symptoms:
- Shortness of breath
- Fatigue
- Fever
- Unintended weight loss
- Cough that brings up blood or mucus
- Wheezing
These symptoms are triggered when you're near sources of airborne spores of Aspergillus fumigatus. This includes compost heaps, damp buildings, and other environments that favor fungi. Your doctor can confirm this diagnosis by some tests that show:
- Eosinophilia (increased numbers of eosinophils, a type of white blood cell, in your blood)
- Skin test reaction to aspergillus antigen tests
- Antibodies to aspergillusin your blood
- Increased blood levels of IgE (a type of immunoglobulin)
- X-ray changes
Aspergillus Fumigatus Treatment
The treatment of this fungal infection requires antifungal drugs, but they're not always effective. Commonly used medicines are amphotericin B, caspofungin, itraconazole, micafungin, and voriconazole.
Aspergillomas are large fungal balls that don't respond well to medicines alone. They should be removed by surgery, and antifungal medicines should be given afterward. Similarly, fungal sinusitis needs the establishment of drainage of the affected sinus. Sinus surgery provides relief, as medicines (antifungals) are not effective in the treatment of fungal sinusitis.
If you have ABPA, your symptoms are allergic in origin. Your doctor will prescribe steroids, such as prednisolone, to control your symptoms. It's not possible to cure the fungal infection completely. But antifungal medicines such as itraconazole can reduce the steroid dose required and the side effects. Another effective drug is omalizumab, an antibody that lowers inflammation in the airways. Controlling inflammation is crucial to prevent ongoing lung damage. It will also relieve your symptoms.
If you've had a stem cell transplant, lung or other organ transplant, or certain other conditions, you're at high risk for Aspergillus fumigatus infection. Your doctor may prescribe antifungal medicines as a preventive measure.
Aspergillus Fumigatus Resistance
Aspergillus fumigatus is sometimes resistant to the commonly used antifungal medicines. Azoles are an important class of antifungal medicines and the most frequently used medicines for treating Aspergillus fumigatus infections. Azole-resistant Aspergillus fumigatus is considered a significant danger by the Centers for Disease Control and Prevention (CDC). Resistance to medicines makes treatment difficult. People with azole-resistant infections are 33% more likely to die.
Takeaways
Aspergillus fumigatus is a type of fungus that can cause infections, especially when your immune system is weakened. This fungus is everywhere — in soil, decaying plants, air-conditioning systems, and household items.
Symptoms of an Aspergillus fumigatus infection include coughing, shortness of breath, fatigue, and weight loss. In severe cases, it can lead to life-threatening conditions, especially in the lungs, and may cause allergic reactions like asthma if you have preexisting lung conditions.
Aspergillus Fumigatus FAQs
How do you get aspergillosis?
You can get aspergillosis by breathing in mold spores that are everywhere — in the air, soil, and air conditioning systems. Normally, healthy people won't get sick, but if you have a weak immune system, you could get sick. Symptoms of an infection include coughing up mucus or blood, wheezing, shortness of breath, feeling tired, or weight loss.
How to get rid of the fungus Aspergillus fumigatus
The best way to get rid of Aspergillus fumigatus is to use antifungal drugs, such as amphotericin B or voriconazole (Vfend), for several weeks. If your lungs or heart are affected, your doctor may also suggest oral corticosteroids, an embolism to prevent bleeding, or surgery if a mass has developed.
What is the life expectancy of someone with aspergillus?
It depends on the type of infection and your immune system. If you have invasive aspergillosis, it means the infection has spread to your lungs or other parts of your body. This is the most severe infection and can be potentially fatal. At least one study of people with chronic pulmonary aspergillosis (CPA) says the survival rate is 86% after a year, 62% in five years, and 47% in 10 years.