Aspergillosis

What is aspergillosis?

Aspergillosis is a term for an infection caused by several types of Aspergillus fungi (plural of fungus). Aspergillus is usually found outdoors, in dead leaves, plants, soil or compost. It’s occasionally found in moist environments indoors. Most people breathe in Aspergillus spores every day without getting sick. But in certain people, Aspergillus can cause allergic reactions, chronic lung conditions and invasive disease that spreads to your brain, kidneys, lungs or other organs.

Is Aspergillus black mold?

Aspergillus isn’t black mold. “Black mold” is a common term used for the fungus Stachybotrys chartarum. This isn’t the same mold that causes aspergillosis, but both are common molds that can make some people sick.

What does aspergillosis feel like?

Aspergillosis can cause symptoms similar to many other illnesses, like fever, cough and shortness of breath. If you’re at risk for aspergillosis, talk to a healthcare provider if you have any of these symptoms.

Who does aspergillosis affect?

• Different types of aspergillosis are more likely to affect certain people:
• Allergic aspergillosis usually affects people with asthma, bronchiectasis or cystic fibrosis.
• Chronic forms of aspergillosis usually affect people with chronic lung conditions, like COPD, sarcoidosis and tuberculosis.
• Invasive aspergillosis usually affects people with a weakened immune system. This includes people who’ve had an organ or stem cell transplant, those who use corticosteroids regularly, those who have diabetes and those with too few of certain white blood cells (neutropenia).

What are the types of aspergillosis?

Types of aspergillosis include:

• Allergic bronchopulmonary aspergillosis (APPA).
• Aspergilloma (“fungus ball”).
• Chronic pulmonary aspergillosis.
• Invasive aspergillosis. Fever is a common symptom.

What are the symptoms of aspergillosis?

Symptoms of aspergillosis vary depending on the type and location in your body. Symptoms of infections or allergic reactions in your lungs are the most common. They include:

• Coughing (sometimes coughing up blood).
• Shortness of breath (dyspnea).
• Noisy breathing (wheezing).
• Chest pain.
• Fever.

Fatigue and weight loss can be symptoms of chronic pulmonary aspergillosis.

You may have additional symptoms if the infection spreads to other parts of your body, including:

What causes aspergillosis?

Many different species of the fungi Aspergillus cause aspergillosis. A. fumigatus is the most common cause.

Aspergillus lives in the environment around us, so we can easily breathe it in. Most people’s bodies eliminate Aspergillus fungus without getting sick. But certain conditions, like a weakened immune system or chronic lung disease, can make it easier to get sick from Aspergillus.

How do you get an Aspergillus infection?

Inhaling Aspergillus from the air can cause an allergic reaction or an infection in your sinuses or lungs. From there, it can move to other parts of your body if your immune system can’t fight off the infection. It can also get into your body through a cut in your skin.

Is aspergillosis contagious?

No, aspergillosis isn’t contagious. You can’t catch it from another person.

How is aspergillosis diagnosed?

How a provider diagnoses aspergillosis depends on your symptoms and health history. Imaging like X-rays or CT scans, tests of fluid or tissue, and allergy tests all help to diagnose various forms of aspergillosis. Its symptoms look similar to many other illnesses, so your provider may need to do additional tests to rule out other conditions.

What tests will be done to diagnose aspergillosis?

Tests a provider may order to diagnose aspergillosis include:

• Allergy tests. Your provider may order blood or skin tests to diagnose allergic or chronic forms of aspergillosis.
• Biopsy. Your provider may take samples of tissue or fluid to test for signs of an Aspergillus infection.
• Blood tests. A blood test can help diagnose invasive aspergillosis early in people who have severely weakened immune systems.
• Culture. Your provider may take samples of your body fluids — such as blood, mucus (sputum), or fluid from around your lungs, brain or spinal cord — and try to grow Aspergillus from it.
• Imaging. Your provider may use X-rays or CT scans to look for signs of Aspergillus in the area of your body they think might be infected.

How is aspergillosis treated?

How your provider treats aspergillosis depends on the type and any underlying conditions you have. Surgery, antifungal medications and corticosteroids are the most common treatment options.

Surgery for aspergillosis

Surgery can often cure aspergillosis caused by a single fungus ball. Providers also use it to treat invasive and allergic aspergillosis in certain circumstances. Providers usually don’t recommend surgery to treat chronic pulmonary aspergillosis.

Antifungal treatments for aspergillosis

Antifungal medications treat many kinds of aspergillosis. If one type of antifungal isn’t working, your provider may prescribe a different one. Possible antifungal treatments include:

• Voriconazole, isavuconazole, posaconazole or itraconazole.
• Liposomal amphotericin B.
• Caspofungin or micafungin.

Corticosteroids for aspergillosis

Corticosteroids (like prednisone, prednisolone and methylprednisolone) reduce inflammation. A provider might prescribe them to treat allergic forms of aspergillosis or skin infections. Which one you’re prescribed depends on where in your body you have an infection. Different types of corticosteroids include:

• Oral (pills you swallow).
• Inhaled (breathed in through your mouth with an inhaler).
• Nasal (a mist you spray into your nose).
• Topical (applied to your skin).

Can aspergillosis be cured?

Surgery or antifungals can cure some types of noninvasive aspergillosis. In some cases, it may go away and come back again (recur). Invasive aspergillosis can be very hard to cure.

How can I prevent aspergillosis?

It’s hard to avoid Aspergillus molds. If you’re at high risk for infection, talk to your provider about the best ways to protect yourself. Your provider might:

• Prescribe an antifungal medicine to prevent infection.
• Test you for signs of infection to make sure you get treated early.

You might be able to reduce your exposure to fungi by:

• Avoiding areas with lots of dust or mold, such as construction sites or compost piles.
• Avoiding activities such as gardening or lawn mowing. If you might be exposed to airborne dust or mold, wear an N95 face mask.

What can I expect if I have aspergillosis?

Everyone’s body responds to aspergillosis differently. What you can expect depends on your health, underlying conditions and what type of aspergillosis you have. Talk to your provider about what to expect in your specific situation. Most people will need follow-up screenings, even if they are successfully treated.

What’s the outlook for aspergillosis?

The outlook for aspergillosis depends on the form:

• Aspergillomas that haven’t invaded tissue usually aren’t dangerous and can be successfully treated with surgery.
• Allergic forms of aspergillosis aren’t usually life-threatening but can cause lung damage if they go untreated for a long time.
• Chronic pulmonary aspergillosis can complicate underlying conditions like COPD. It can be life-threatening. Treatment often helps symptoms, but the infection can come back again and again.
• Invasive aspergillosis can be life-threatening. Since people with invasive aspergillosis almost always have an immune system that can’t fight off the infection, it can be hard to treat. If you have invasive aspergillosis, you’ll need to be treated as soon as possible and monitored closely.

Aspergillosis complications

Your risk of experiencing complications depends on which type of aspergillosis you have. All types can cause lung damage, including:

• Scarring (fibrosis).
• Widening of your airways (bronchiectasis).
• Collapsed areas of lung (atelectasis).

Invasive and chronic aspergillosis can cause additional complications, including:

• Moving to and damaging other organs.
• Tissue destruction.
• Respiratory failure.
• Sepsis.

When should I see a healthcare provider?

Ask a healthcare provider how to prevent and detect fungal infections early if you:

• Have had an organ or stem cell transplant.
• Are on chemotherapy for cancer.
• Have HIV or AIDS.
• Have diabetes.
• Have a chronic lung condition, such as asthma, COPD, sarcoidosis or tuberculosis.
• Have a condition or take medications that weaken your immune system.

When should I go to the ER?

If you have symptoms of any kind of infection and you have a weakened immune system, talk to your provider right away or seek emergency care. Go to the nearest emergency room if you have symptoms of serious illness, including:

• High fever (over 103 degrees Fahrenheit/40 degrees Celsius).
• Difficulty breathing.
• Coughing up blood.
• Confusion or other mental changes.
• Seizures.
• Black skin, tissue or mucus.
• Blue skin, lips or nails (cyanosis, a sign of low oxygen in your blood).

What questions should I ask my doctor?

• Which type of aspergillosis do I have?
• How do I take my medications?
• What are my treatment options?
• What are the risks of treatment?
• How can I treat my symptoms at home?
• What precautions should I take to avoid fungal infections?
• Can I detect a fungal infection early?

A note from Cleveland Clinic

Aspergillosis is a broad term for many types of illnesses caused by species of Aspergillus fungi. Some forms are mild, but some cause life-threatening illness. Talk to your healthcare provider about what to expect in your specific situation. If you have a weakened immune system or a lung condition, ask your provider about prevention and early detection.