Aspergillosis

Aspergillosis
Pulmonary invasive aspergillosis in a person with interstitial pneumonia (autopsy material), using Grocott's methenamine silver stain
Pronunciation
SpecialtyInfectious disease
ComplicationsBleeding, systemic infection[1]
CausesAspergillus fungal infection
Frequency14 million

Aspergillosis is a fungal infection of usually the lungs,[2] caused by the genus Aspergillus, a common mould that is breathed in frequently from the air, but does not usually affect most people.[3][4] It generally occurs in people with lung diseases such as asthma, cystic fibrosis or tuberculosis, or those who are immunocompromised such as those who have had a stem cell or organ transplant or those who take medications such as steroids and some cancer treatments which suppress the immune system.[2][5] Rarely, it can affect skin.[5][6]

Aspergillosis occurs in humans, birds and other animals. Aspergillosis occurs in chronic or acute forms which are clinically very distinct. Most cases of acute aspergillosis occur in people with severely compromised immune systems such as those undergoing bone marrow transplantation.[7] Chronic colonization or infection can cause complications in people with underlying respiratory illnesses, such as asthma,[8] cystic fibrosis,[9] sarcoidosis,[10] tuberculosis, or chronic obstructive pulmonary disease.[11] Most commonly, aspergillosis occurs in the form of chronic pulmonary aspergillosis (CPA), aspergilloma, or allergic bronchopulmonary aspergillosis (ABPA).[12] Some forms are intertwined; for example ABPA and simple aspergilloma can progress to CPA.

Other, noninvasive manifestations include fungal sinusitis (both allergic in nature and with established fungal balls), otomycosis (ear infection), keratitis (eye infection), and onychomycosis (nail infection). In most instances, these are less severe, and curable with effective antifungal treatment.

The most frequently identified pathogens are Aspergillus fumigatus and Aspergillus flavus, ubiquitous organisms capable of living under extensive environmental stress. Most people are thought to inhale thousands of Aspergillus spores daily but without effect due to an efficient immune response. Invasive aspergillosis has a 20% mortality at 6 months.[13] The major chronic, invasive, and allergic forms of aspergillosis account for around 600,000 deaths annually worldwide.[10][14][15][16][17]

  1. ^ "Aspergillosis". mayoclinic.org. Mayo Clinic. Retrieved June 5, 2022.
  2. ^ a b Thornton CR (2020). "1. Detection of the 'Big Five' mold killers of humans: Aspergillus, Fusarium, Lomentospora, Scedosporium and Mucormycetes". In Gadd GM, Sariaslani S (eds.). Advances in Applied Microbiology. Academic Press. pp. 4–22. ISBN 978-0-12-820703-1.
  3. ^ "ICD-11 - ICD-11 for Mortality and Morbidity Statistics". World Health Organization. Retrieved 29 May 2021.
  4. ^ "Aspergillosis | About". www.cdc.gov. 10 May 2021. Retrieved 1 June 2021.
  5. ^ a b Kutzner H, Kempf W, Feit J, Sangueza O (2021). "2. Fungal infections". Atlas of Clinical Dermatopathology: Infectious and Parasitic Dermatoses. Hoboken: Wiley Blackwell. p. 103-104. ISBN 978-1-119-64706-5.
  6. ^ Johnstone RB (2017). "25. Mycoses and Algal infections". Weedon's Skin Pathology Essentials (2nd ed.). Elsevier. p. 463. ISBN 978-0-7020-6830-0.
  7. ^ "Invasive pulmonary aspergillosis | Aspergillus & Aspergillosis Website". The Aspergillus Website. Archived from the original on 26 July 2020. Retrieved 28 June 2019.
  8. ^ Denning DW, Pashley C, Hartl D, Wardlaw A, Godet C, Del Giacco S, et al. (15 April 2014). "Fungal allergy in asthma-state of the art and research needs". Clinical and Translational Allergy. 4 (1): 14. doi:10.1186/2045-7022-4-14. PMC 4005466. PMID 24735832.
  9. ^ Warris A, Bercusson A, Armstrong-James D (April 2019). "Aspergillus colonization and antifungal immunity in cystic fibrosis patients". Medical Mycology. 57 (Supplement_2): S118–S126. doi:10.1093/mmy/myy074. hdl:2164/13751. PMID 30816976.
  10. ^ a b Denning DW, Pleuvry A, Cole DC (March 2013). "Global burden of chronic pulmonary aspergillosis complicating sarcoidosis". The European Respiratory Journal. 41 (3): 621–626. doi:10.1183/09031936.00226911. PMID 22743676. S2CID 8823691.
  11. ^ Smith NL, Denning DW (April 2011). "Underlying conditions in chronic pulmonary aspergillosis including simple aspergilloma". The European Respiratory Journal. 37 (4): 865–872. doi:10.1183/09031936.00054810. PMID 20595150. S2CID 18292691.
  12. ^ Goel A. "Pulmonary aspergillosis". Mediconotebook. Retrieved 29 May 2015.
  13. ^ Thompson, George R.; Young, Jo-Anne H. (14 October 2021). "Aspergillus Infections". New England Journal of Medicine. 385 (16): 1496–1509. doi:10.1056/NEJMra2027424. PMID 34644473.
  14. ^ Guinea J, Torres-Narbona M, Gijón P, Muñoz P, Pozo F, Peláez T, et al. (July 2010). "Pulmonary aspergillosis in patients with chronic obstructive pulmonary disease: incidence, risk factors, and outcome". Clinical Microbiology and Infection. 16 (7): 870–877. doi:10.1111/j.1469-0691.2009.03015.x. PMID 19906275.
  15. ^ Chen J, Yang Q, Huang J, Li L (September 2013). "Risk factors for invasive pulmonary aspergillosis and hospital mortality in acute-on-chronic liver failure patients: a retrospective-cohort study". International Journal of Medical Sciences. 10 (12): 1625–1631. doi:10.7150/ijms.6824. PMC 3804788. PMID 24151434.
  16. ^ Garcia-Vidal C, Upton A, Kirby KA, Marr KA (October 2008). "Epidemiology of invasive mold infections in allogeneic stem cell transplant recipients: biological risk factors for infection according to time after transplantation". Clinical Infectious Diseases. 47 (8): 1041–1050. doi:10.1086/591969. PMC 2668264. PMID 18781877.
  17. ^ Nam HS, Jeon K, Um SW, Suh GY, Chung MP, Kim H, et al. (June 2010). "Clinical characteristics and treatment outcomes of chronic necrotizing pulmonary aspergillosis: a review of 43 cases". International Journal of Infectious Diseases. 14 (6): e479–e482. doi:10.1016/j.ijid.2009.07.011. PMID 19910234.