Aspergillus

Question 1

What are the aspergillus species

Answer 1

Fumigatus

Flavus - forms the aflatoxin which causes hepatocellular carcinoma.

Niger

Versicolor

Terreus

They all can cause all the different diseases, and are distiguished by their colony color and condiophore structure

Question 2

Morphology

Answer 2

Is a hyaline mold (not dimorphic)

Branched, at acute angles, 45 degree or less.
Septate hyphae

Question 3

Habitat and Transmission

Answer 3

By inhalation of conidiophores in the air.

Flavus is common on peanuts and wheat crops

Question 4

Disease

Answer 4

1) ABPA Allergic BronchPulmonary Aspergillosis
- Type 1 hypersensitivity reaction causing wheezing/asthma type cough, with fever and pulmonary infiltrates
- increased IgE

2) Aspergillomas
Fungus balls, which are typically secondary infections to pre-formed cavities in the lungs.
Infect TB caivites, Klebsiella cavities.
Will be at the bottom of the cavity on a chest X-ray

3) Angioinvasive Aspergillosis
In immunocompromised
Specifically neutropenic patients from leukemia or lymphoma.

Invades blood vessels and disseminates

Kidney failure
Endocarditis
Ring enhancing brain lesions
Paranasal sinus invasion and facial necrosis. (must then be distinguished from mucor)

Question 5

Aspergillosis diagnosis

Answer 5

Lung biopsy and grocott stain.

Question 6

Biochemical characteristics

Answer 6

Catalase positive

Question 7

Treatment

Answer 7

Conazoles,
specifically: Voraconazole (tornado-vortex) for lung infections.

Surgical debridement

Amphotericin B for invasive disease