MSD Manual

Please confirm that you are not located inside the Russian Federation

honeypot link

Aspergillosis

By

Sanjay G. Revankar

, MD, Wayne State University School of Medicine

Last full review/revision Apr 2021| Content last modified Apr 2021
Click here for the Professional Version
Topic Resources

Aspergillosis is an infection, usually of the lungs, caused by the fungus Aspergillus.

  • A ball of fungus fibers, blood clots, and white blood cells may form in the lungs or sinuses.

  • People may have no symptoms or may cough up blood or have a fever, chest pain, and difficulty breathing.

  • If fungi spread to the liver or kidneys, these organs may malfunction.

  • Diagnosis usually involves an x-ray or computed tomography and, if possible, culture of a sample of infected material.

  • Antifungal drugs are used, and sometimes surgery is needed to remove the fungal balls.

Aspergilli are very common in the environment—indoors and out—and frequently occur in compost heaps, air vents, and airborne dust. These fungi are thus unavoidable.

Usually, aspergillosis is caused by inhaling Aspergillus spores. Most people inhale these spores every day without being affected. But if the immune system is weak, infection is more likely because aspergillosis is an opportunistic fungal infection Opportunistic fungal infections Fungi are neither plants nor animals. They were once thought to be plants but are now classified as their own kingdom. Some fungi cause infections in people. Because fungal spores are often... read more (one that takes advantage of a weakened immune system). The immune system may be weakened by the following:

  • Disorders that affect the immune system (including AIDS and some hereditary disorders)

  • Cancer

  • Drugs such as corticosteroids (if high doses are taken for a long time), cancer chemotherapy, or drugs used to prevent an organ transplant from being rejected

Aspergillosis has several forms:

Symptoms of Aspergillosis

Pulmonary aspergillosis

A fungus ball in the lungs may cause no symptoms and may be discovered only when a chest x-ray is taken for other reasons. Or it may cause repeated coughing up of blood and, rarely, severe, even fatal bleeding.

Invasive aspergillosis

A rapidly invasive infection in the lungs often causes cough, fever, chest pain, and difficulty breathing. Without treatment, this form of invasive aspergillosis is fatal.

Aspergillosis that spreads to other organs makes people very ill. Symptoms include fever, chills, shock, delirium, and blood clots. Kidney failure, liver failure (causing jaundice), and breathing difficulties may develop. Death can occur quickly.

Superficial aspergillosis

Aspergillosis of the ear canal causes itching and occasionally pain. Fluid draining overnight from the ear may leave a stain on the pillow.

Aspergillosis of the sinuses causes a feeling of congestion and sometimes pain or discharge or bleeding from the nose.

Diagnosis of Aspergillosis

  • Culture, examination, and analysis of a sample of infected material

Doctors suspect aspergillosis based on symptoms. An x-ray or computed tomography (CT) of the infected area also provides clues for making the diagnosis.

Treatment of Aspergillosis

  • Antifungal drugs

  • Sometimes surgery to remove fungi

Aspergillosis that affects only a sinus or a single area in the lung requires treatment but does not pose an immediate danger because it progresses slowly. However, if the infection is widespread or if people appear seriously ill or have a weakened immune system, treatment is started immediately.

Invasive aspergillosis is treated with antifungal drugs, such as voriconazole, isavuconazole, or sometimes posaconazole or itraconazole. However, some forms of Aspergillus do not respond to these drugs and may need to be treated with amphotericin B or with a combination of drugs. Any condition that is weakening the immune system should be corrected if possible. For example, doctors may advise people who are taking corticosteroids, which suppress the immune system, to stop.

Aspergillosis in the ear canal is treated by scraping out the fungus and applying drops of antifungal drugs. Collections of fungi in the sinuses must usually be removed surgically.

Fungus balls in the lungs (aspergillomas) usually do not require treatment with drugs and do not usually respond to drugs. If these balls cause bleeding (causing people to cough up blood) or other symptoms, they may need to be removed surgically. Surgery cures the infection but is often risky because many of these people have other disorders.

NOTE: This is the Consumer Version. DOCTORS: Click here for the Professional Version
Click here for the Professional Version
Others also read
Download the Manuals App iOS ANDROID
Download the Manuals App iOS ANDROID
Download the Manuals App iOS ANDROID
Test your knowledge
Dengue
Dengue is a viral infection that causes fever, aches throughout the body, and, in severe cases, bleeding in multiple areas. How is the dengue virus transmitted? 
Download the Manuals App iOS ANDROID
Download the Manuals App iOS ANDROID
Download the Manuals App iOS ANDROID

Also of Interest

Download the Manuals App iOS ANDROID
Download the Manuals App iOS ANDROID
Download the Manuals App iOS ANDROID
TOP