Aspergillosis

Infection with the fungus Aspergillus, seen especially in people with a deficient immune system. The clinical features of aspergillosis can include invasive lung infection and disseminated disease, usually with fever, cough, spitting up blood, and chest pain. Aspergillosis may mimic asthma with cough and inspiratory stridor (noise on breathing in) or sinusitis with fever, localized pain. Aspergillosis is due most often to Aspergillus fumigatus or Aspergillus flavus and less commonly A. niger, A. terreus, or A. nidulans. These fungi frequently colonize the upper respiratory tract and are among the most common in the environment. At elevated risk for aspergillosis are people with a blood malignancy or lymphoma, anyone who has had a transplant or is taking high-dose corticosteroids and, rarely, people with HIV infection. Diagnosis may be difficult. It usually requires a biopsy. The advent of effective, less toxic antifungal drugs (such as itraconazole) has improved therapy. The prognosis (outlook) with aspergillosis depends on the early institution of effective antifungal drug therapy or on regaining more normal immune function.

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The presence of the fungus Aspergillus in the tissues or invading tissue (invasive a.) or colonizing air-containing body cavities. SEE ALSO: aspergilloma.

- acute invasive a. an aggressive infection, particularly in severely immunocompromised people, which consists of invasion of blood vessel s and tissue infarction by Aspergillus fumigatus. The disease often mimics the signs and symptoms of acute bacterial pneumonia.

- allergic bronchopulmonary a. a disease in which the fungus grows in mucus (evoked by inflammation), which may be expectorated as yellow bronchial casts and cause intermittent bronchial obstruction, with transient infiltrates seen radiographically; asthma is often present, and bronchial wall destruction may eventually result in a proximal form of bronchiectasis.

- chronic necrotizing a. an indolent but slowly progressive infection of the lungs in patients with underlying lung disease, caused by aspergillus. Most affected patients have a modest depression of the immune system, caused by diseases such as diabetes.

- disseminated a. a variety of bronchopulmonary a., characterized by a generalized infection of the lung with Aspergillus occurring usually in subjects with defective immune response.

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as·per·gil·lo·sis .as-pər-(.)jil-'ō-səs n, pl -lo·ses -.sēz infection with or disease caused (as in poultry) by molds of the genus Aspergillus

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n.

a group of conditions caused by fungi of the genus Aspergillus, usually Aspergillus fumigatus. These conditions nearly always arise in patients with pre-existing lung disease and fall into three categories. The allergic form most commonly affects asthmatic patients and may cause collapse of segments or lobes of a lung. The colonizing form leads to formation of a fungus ball (aspergilloma), usually within a pre-existing cavity in the lung (such as an emphysematous bulla or a healed tuberculous cavity). Similar fungus balls may be found in other cavities, such as the eye or the sinuses around the nose. The third form of aspergillosis, in which the fungus spreads throughout the lungs and may even disseminate throughout the body, is rare but potentially fatal. It is usually associated with deficiency in the patient's immunity.

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as·per·gil·lo·sis (as″pər-jil-oґsis) infection by species of Aspergillus, marked by inflammatory granulomatous lesions in the skin, ear, orbit, nasal sinuses, lungs, and sometimes the bones and meninges; called also aspergillomycosis.