Aspergillus Lung DIsease

Question 1

Define Aspergillus Lung disease

Answer 1

Infection caused by the fungi Aspergillus that can affect the lung in five ways:

1. asthma
2. allergic bronchopulmonary aspergillosis (ABPA)
3. aspergillosis (mycetoma)
4. invasive aspergillosis
5. extrinsic allergic alveolitis

Question 2

Aetiology of Aspergillus Lung disease

Answer 2

Neutropenia and compromised T-lymphocyte.macrophage function predispose to infection
Humans routinely inhale the aerosolise conidia, but this is promptly eliminated from the respiratory tract

Aspergillus fumigatus is the most common pathogenic species (50-70%)

Question 3

Risk Factors for Aspergillus Lung disease

Answer 3

Allergenic stem cell transplant 
Prolonged severe neutropenia 
Immunosuppressive therapy 
Chronic granulomatous disease 
Organ transplantation 
Acute leukaemia 
Aplastic anaemia 
Invasive aspergillosis - immunocompromise e.g. HIV< leukaemia, burns, Wegener’s , SLE

Question 4

Symptoms of Aspergillus Lung disease

Answer 4

Asthma: SOB on exertion and with triggers. Nocturnal cough

Allergic bronchopulmonary aspergillosis: Wheeze, cough, sputum, dyspnoea, recurrent pneumonia

Mycetoma: asymptomatic, otherwise cough, haemoptysis , lethargy or weight loss

Invasive aspergillosis: cough, headache, fever, pleuritic chest pain, nasal ulcer, skin rash

Question 5

Signs of Aspergillus Lung disease on examination

Answer 5

Pleural rub
Cranial nerve palsy
Malaise

Question 6

Investigations for Aspergillus Lung disease

Answer 6

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