Aspergillus

Question 1

What is the most common cause of invasive aspergillosis?

Answer 1

A. Fumigatus

Question 2

What are the distinctive characteristics of aspergillum?

Answer 2

It grows as a colorless filamentous mold with septet hyphae and extensive branching at acute angles of 45 degrees.

Question 3

How do aspergillus reproduce?

Answer 3

Through asexual reproduction as aerial hyphae and classical aerial conidiophores. The conidia get airborne very easily.

Question 4

What is the most notable toxin produced by aspergillus and what organs is it toxic to?

Answer 4

Aflatoxin that is cariogenic and hepatotoxic.

Question 5

Where do aspergillus grow?

Answer 5

In the environment on living and dead organic matter.

Question 6

Transmission of aspergillus?

Answer 6

Inhalation of airborne spores (conidia) which germinate and begin to grow or initiate allergic reactions.

Question 7

In what susceptible populations is bloodstream invasion by aspergillus seen?

Answer 7

Only in the immunocompromised!

Question 8

What are the allergic reactions caused by aspergillus?

Answer 8

upper respiratory allergies, hypersensitivity pneumonitis, allergic bronchopulmonary aspergillosis and allergic fungal sinusitis.

Question 9

What population is ABPA common in?

Answer 9

Asthmatics and cystic fibrosis pts.

Question 10

What are the localized infections caused by aspergillus?

Answer 10

Aspergilloma, chronic necrotizing aspergillus pneumonia, otomycosis and skin/subcutaneous infection

Question 11

Where do aspergillomas grow?

Answer 11

In an old pre-existing cavity in the lungs! It forms a fungal ball

Question 12

Where does chronic necrotizing aspergillus pneumonia grow?

Answer 12

It doesn’t require a pre-existing cavity!

Question 13

What population is chronic necrotizing aspergillus pneumonia seen in?

Answer 13

Always seen in patients with underlying disease!

Question 14

What can chronic necrotizing aspergillus pneumonia be confused with?

Answer 14

TB

Question 15

What is otomycosis?

Answer 15

A chronic ear infection, common in the tropics.

Question 16

How does aspergillus cause skin infections?

Answer 16

Spores enter the skin through skin trauma.

Question 17

Do invasive lung infections by aspergillus stay confined to a cavity?

Answer 17

NO. It is invasive so it can extend to new areas of the lung.

Question 18

What type of infection by aspergillus has the highest mortality?

Answer 18

Bloodstream dissemination tot he brain, eye, heart, kidneys, and skin.

Question 19

Diagnosis for Aspergillus

Answer 19

Imaging studies
Appropriate samples 
Direct microscopic examination looking for 45 degree branching hyphae 
Culture-slow! 
Molecule detection tests

Question 20

What are non-cultrure detection assays for aspergillus

Answer 20

Aspergillus antigen detection in the serum for galactomannan antigen.

Question 21

Treatment for aspergillus allergic reactions

Answer 21

Antihistamins, corticosteroids, itraconazole, possible surgical debridement.

Question 22

Treatment for aspergillus infections

Answer 22

Surgery to remove fungal balls, voriconazole for invasive infection, empiric therapy for susceptive invasive therapy ASAp, caspofungin, itraconazole and posaconazole.

Question 23

Is there a vaccine for aspergillus?

Answer 23

NO

Question 24

What are the prevention measures for aspergillus?

Answer 24

HEPA filtered clean rooms, Anti-fungal prophylaxis