Aspergillosis

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Aspergillosis
Classification and external resources
Histopathologic image of pulmonary invasive aspergillosis in a patient with interstitial pneumonia. Autopsy material. Grocott's methenamine silver stain.
ICD-10 B44.
ICD-9 117.3
MedlinePlus 001326
eMedicine med/174 
MeSH D001228

Aspergillosis is the name given to a wide variety of diseases caused by fungi of the genus Aspergillus. The most common forms are allergic bronchopulmonary aspergillosis, pulmonary aspergilloma and invasive aspergillosis. Most humans inhale Aspergillus spores every day; aspergillosis develops mainly in immunocompromised individuals. The most common cause is Aspergillus fumigatus.

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[edit] Symptoms

A fungus ball in the lungs may cause no symptoms and may be discovered only with a chest x-ray. Or it may cause repeated coughing up of blood and occasionally severe, even fatal, bleeding. A rapidly invasive Aspergillus infection in the lungs often causes cough, fever, chest pain, and difficulty breathing.

Aspergillosis affecting the deeper tissues makes a person very ill. Symptoms include fever, chills, shock, delirium, and blood clots. The person may develop kidney failure, liver failure (causing jaundice), and breathing difficulties. Death can occur quickly.

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.

In addition to the symptoms, an x-ray or computerised tomography (CT) scan of the infected area provides clues for making the diagnosis. Whenever possible, a doctor sends a sample of infected material to a laboratory to confirm identification of the fungus.

[edit] Diagnosis

On chest X-ray and computed tomography pulmonary aspergillosis classically manifests as an air crescent sign.[1]

[edit] Treatment

The drugs amphotericin B, caspofungin, flucytosine, itraconazole, voriconazole [2] are used to treat this fungal infection.

[edit] Outbreaks

Albeit relatively rare in humans, aspergillosis is a common and dangerous infection in birds, particularly in pet parrots. Mallards and other ducks are particularly susceptible as they will often resort to poor food sources during bad weather.

Aspergillosis has been the culprit in several recent rapid die-offs among waterfowl. From 8 December until 14 December 2006 over 2,000 Mallards died in the Burley, Idaho area, an agricultural community approximately 150 miles southeast of Boise. Moldy waste grain from the farmland and feedlots in the area is the suspected source. A similar aspergillosis outbreak caused by moldy grain killed 500 Mallards in Iowa in 2005.

While there is no connection between aspergillosis and the H5N1 strain of Avian Influenza (commonly called "bird flu"), rapid die-offs caused by aspergillosis can spark fears of bird flu outbreaks. Laboratory analysis is the only way to distinguish bird flu and aspergillosis.

[edit] References

  1. ^ Curtis A, Smith G, Ravin C (Oct 1979). "Air crescent sign of invasive aspergillosis.". Radiology 133 (1): 17–21. PMID 472287. 
  2. ^ Herbrecht R, Denning D, Patterson T, Bennett J, Greene R, Oestmann J, Kern W, Marr K, Ribaud P, Lortholary O, Sylvester R, Rubin R, Wingard J, Stark P, Durand C, Caillot D, Thiel E, Chandrasekar P, Hodges M, Schlamm H, Troke P, de Pauw B; Invasive Fungal Infections Group of the European Organisation for Research and Treatment of Cancer and the Global Aspergillus Study Group. (Aug 8 2002). "Voriconazole versus amphotericin B for primary therapy of invasive aspergillosis.". N Engl J Med 347 (6): 408–15. doi:10.1056/NEJMoa020191. PMID 12167683. 

[edit] External links

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Dimorphic fungi
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