pulmonary aspergillosis

Aspergillus Species

  • most common species: A. fumigatus, A. flavus, A. niger, and the amphotericin-resistant A. terreus.

Types

The spores of the fungal species classified as Aspergillus are ubiquitous in most regions of North America and are routinely inhaled by humans. This exposure is of little consequence in most instances, but disease does occur in several settings. Some individuals develop hypersensitivity to the inhaled antigens and, over time, develop allergic bronchopulmonary aspergillosis, manifested by severe asthma, bronchiectasis, and fleeting lung infiltrates. Individuals with structural lung disease such as emphysema or cystic sarcoidosis may develop fungus balls (aspergillomas) in lung cavities or other forms of chronic aspergillosis. The most serious consequence of these fungal accretions is hemoptysis, which may be massive and recurrent. Other aspergillosis infection includes various patterns of chronic PA.  Risk factors for chronic PA include prior lung disease such as pulmonary tuberculosis, ABPA, lung cancer, chronic obstructive pulmonary disease, and sarcoidosis.

The most rapidly progressive and lethal consequence of exposure to Aspergillus spores is invasive aspergillosis, which occurs in patients who are immunosuppressed, with the lung the most commonly recognized site of infection, although dissemination via circulation can occur.

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