Aspergillus Lung Disease

Question 1

Define aspergillus lung disease

Answer 1

infection of the lungs caused by the fungus Aspergillus

A ball of fungus fibers, blood clots, and white blood cells may form in the lungs or sinuses

Question 2

What are the causes/risk factors of aspergillus lung disease?

Answer 2

The illness is the result of a combination of exposure to the Aspergillus fungus and a weak immune system. The following may carry the fungus:

• compost piles
• stored grain
• marijuana leaves
• decaying vegetation

risk factors:

• allogeneic stem cell transplantation
• prolonged severe neutropenia (>10 days)
• immunosuppressive therapy
• chronic granulomatous disease (CGD)
• solid organ transplantation (SOT)
• acute leukaemia
• aplastic anaemia
• pre-existing cavity (aspergilloma)

Question 3

What are the signs and symptoms of aspergillus lung disease?

Answer 3

• cough
• headache
• fever
• congested/ tender sinuses
• chest pain
• SOB
• difficult to control asthma
• recurrent episodes of pneumonia with wheeze, cough, fever and malaise
• dyspnoea
• rapid deterioration
• septic picture

signs

• tracheal deviation (very large)
• dullness in affected lung
• reduced bs
• wheeze
• cyanosis

Question 4

What are the investigations for aspergillus lung disease?

Answer 4

• CXR - invasive aspergillosis: nodules, consolidation, non-specific infiltrates, pleural-based lesions and cavities; may be normal; aspergilloma: upper lobe mobile intracavitary mass with an air-crescent in the periphery
• high-resolution chest CT scan - Invasive aspergillosis: specific: nodules (1 cm or more in size) with or without halo sign or air-crescent sign; non-specific: micronodules, infiltrates, ground-glass opacities, pleural effusions; aspergilloma: upper-lobe cavitary mass with intracavitary contents with adjacent pleural thickening
• high-resolution sinuses CT scan - opacity/mass within the sinus cavity, bone erosion of the surrounding sinus walls
• high-resolution brain CT scan - focal lesions
• MRI brain - space-occupying lesions with surrounding oedema, abscesses, haemorrhage
• MRI sinuses - sinus opacity and/or bone erosion
• serum Aspergillus galactomannan (GM) antigen by enzyme immunoassay (EIA)
• sputum smear - positive for hyphal elements (Sputum is usually absent in patients with pulmonary aspergillosis)
• sputum culture