How is aspergillosis treated?
Treatment options include oral corticosteroids, antifungal medications, and surgery.
- Oral corticosteroid drugs: Solid or liquid oral medications may be prescribed to treat allergic bronchopulmonary aspergillosis. These drugs reduce inflammation and prevent respiratory symptoms, such as wheezing and coughing, from getting worse. Some of the most commonly used drugs are prednisone, prednisolone, and methylprednisolone.
- Antifungal drugs: These medications are generally used to treat invasive pulmonary aspergillosis. Voriconazole is currently the drug of choice because it causes fewer side effects and appears to be more effective than other medications. Amphotericin B or itraconazole are also effective in treating infection. Caspofungin is sometimes used in cases where the infection is resistant to the other antifungals. Antifungal drugs are sometimes used along with oral corticosteroids when treating ABPA. Antifungals can cause serious side effects, such as kidney and liver damage.
- Surgery: Surgery may be necessary in cases when aspergillomas are present and cause serious problems, such as excessive bleeding. Antifungal medications are usually not effective against aspergillomas, so surgery is recommended. Embolization may be an option to block blood flow to the artery supplying blood to the lung cavity where the fungus ball is located. This will stop the bleeding, but it may recur later.