Aspergillosis is an infectious disease that occurs due to a common type of fungus, or mold, called Aspergillus. A type of aspergillosis called invasive aspergillosis particularly affects people with weakened immune systems.

Most individuals breathe Aspergillus spores daily and do not develop any health effects.

However, people with compromised immune systems, such as those who have had an organ transplant or are undergoing chemotherapy treatment, may be at greater risk of developing aspergillosis.

The disease usually affects the lungs but can spread to other areas of the body.

This article looks at invasive aspergillosis and its symptoms, diagnosis, outlook, and more.

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Aspergillus mold is common indoors and outdoors and can cause infection in the sinuses and lungs of immunocompromised people.

If the infection spreads to the rest of the body, outcomes are very unfavorable and include death.

Experts do not know the extent of aspergillosis in the United States, as it is not a reportable infection. However, according to a database of insurance claims, there were almost 15,000 hospitalizations for this diagnosis in the U.S. in 2014.

That said, the number of people with aspergillosis has likely increased since then.

Invasive aspergillosis is less common than the milder, allergic forms of the disease. It is the most common fungal infection in people who have had stem cell treatment. It is also the second most common in those who have received solid organ transplants.

Invasive aspergillosis usually occurs in people with weakened immune systems who often already have other medical conditions. Therefore, it can be difficult to differentiate between the symptoms of the infection and those of the underlying illness.

The symptoms of invasive aspergillosis may include:

Types of invasive aspergillosis include:

  • Chronic pulmonary aspergillosis: In this type, Aspergillus infection causes cavities and sometimes balls of fungus in the lungs.
  • Cutaneous aspergillosis: This type of aspergillosis occurs when the fungus enters the body through a wound in the skin, such as after surgery, and causes infection. It usually affects people with immune system issues. Cutaneous aspergillosis can also occur when invasive aspergillosis spreads to the skin from another area of the body, such as the lungs.

Other types of aspergillosis include:

  • Aspergilloma: Doctors also refer to aspergilloma as a fungus ball. This form of the disease occurs when a ball of Aspergillus fungus grows inside the sinuses or lungs. It typically does not spread to other areas of the body.
  • Allergic bronchopulmonary aspergillosis (ABPA): This occurs when Aspergillus mold causes lung inflammation but does not cause infection. A person with ABPA may experience allergy symptoms such as wheezing and coughing.
  • Allergic Aspergillus sinusitis: This occurs when Aspergillus mold causes inflammation of the sinuses. It produces symptoms of a sinus infection such as headache and stuffiness. However, it does not cause infection.
  • Azole-Resistant Aspergillus fumigatus:This type of aspergillosis occurs when a particular species of Aspergillus mold, called A. fumigatus, becomes resistant to certain medications that doctors use to treat it. People with this type of resistant infection may not recover with treatment.

A person can develop aspergillosis by breathing in Aspergillus spores, which are common in indoor and outdoor environments.

Most people will not get sick from breathing the spores, but those with weakened immune systems are at greater risk of infection.

People at risk of invasive aspergillosis include individuals with weakened immune systems, such as those who have received:

Additionally, hospitalized patients with severe influenza and those with HIV are at risk of invasive aspergillosis.

To diagnose aspergillosis, a doctor may examine a person’s medical history and risk factors and ask questions about their symptoms.

They may perform a physical examination and several laboratory tests. These may include:

Doctors may treat invasive aspergillosis with several different antifungal medications.

These may include:

  • voriconazole
  • posaconazole
  • itraconazole
  • isavuconazole
  • lipid amphotericin formulations
  • micafungin
  • caspofungin

Where possible, doctors may also decrease or discontinue immunosuppressive medications to help treat invasive aspergillosis.

Because Aspergillus spores are common in the environment, it is difficult for people to avoid breathing them in.

Experts recommend those with weakened immune systems take certain measures to protect against the fungus. However, these actions may not prevent aspergillosis.

Preventive measures may include:

  • avoiding activities that involve contact with dust or soil — people can also wear protective clothing
  • wearing gloves while handling materials such as moss or manure
  • avoiding areas that contain excessive dust, such as construction sites, or wearing protective gear, such as an N95 respirator face mask
  • cleaning skin injuries thoroughly
  • taking antifungal medication
  • testing for early infection

The outlook for invasive aspergillosis is generally unfavorable.

The mortality rate of invasive pulmonary aspergillosis is about 20% six weeks after diagnosis, despite treatment with antifungal medications.

The mortality rate reaches close to 100% once the infection has spread to the central nervous system.

Most people safely breathe Aspergillus spores every day, as these are common in indoor and outdoor environments.

However, those with weakened immune systems may be at risk of developing health problems from breathing microscopic amounts of the fungus.

In immunocompromised people, such as those undergoing chemotherapy or those who have had stem cell or organ transplants, invasive aspergillosis may affect the lungs and sinuses. This can cause symptoms such as shortness of breath and coughing up blood.

The disease may spread to other areas of the body and is often fatal once it reaches the central nervous system.

Treatment for invasive aspergillosis typically includes the use of antifungal medication.

Doctors may advise high risk individuals who are immunocompromised to take measures that may help prevent aspergillosis. These approaches include wearing protective equipment and clothing, testing, and taking antifungal drugs.