Aspergillus lung disease

Question 1

What is Aspergillosis?

Answer 1

Filamentous fungi of the Aspergillus species are ubiquitously found as soil inhabitants. Inhalation of the aerosolised conidia (spores) causes the infection.

Question 2

What are the risk factors of Aspergillosis?

Answer 2

> 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 Aspergillosis?

Answer 3

> Pleuritic chest pain
> Pleural rub
> Nasal ulcer
> Skin rash
> Cough
> Headache
> Fever
> Congestion or sinus tenderness
> Haemoptysis/ dyspnoea/ facial pain/ seizure/ malaise/ weight loss

Question 4

What is the epidemiology of Aspergillosis?

Answer 4

Usually in immunocompromised hosts such as cancer and transplant patients

Question 5

What investigations would you do for aspergillosis?

Answer 5

> CXR- nodules, infiltrates, cavities, lesions
High resolution CT of chest, sinuses and brain- nodules, masses, bone erosions, local lesions
MRI brain and sinuses- sinus opacity, bone erosion, space occupying lesion
Sputum smear and culture- shows hyphae and aspergillus species
Serum Aspergillus galactomannan antigen by EIA- positive