Aspergillosis

Aspergillosis
Histopathologic image of pulmonary invasive aspergillosis in a patient with interstitial pneumonia. Autopsy material. Grocott's methenamine silver stain.
ICD-10	B44
ICD-9	117.3
MedlinePlus	001326
MeSH	D001228

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Aspergillosis is the name given to a wide variety of diseases caused by the genus of fungi Aspergillus. The most common forms are allergic bronchopulmonary aspergillosis, pulmonary aspergilloma and invasive aspergillosis. Compromised immune systems often allow Aspergillus to colonize.

Symptoms

A fungus ball in the lungs may cause no symptoms and may be discovered only with a chest x-ray. Or it may cause repeated coughing up of blood and—rarely—severe, even fatal, bleeding. A rapidly invasive Aspergillus infection in the lungs often causes cough, fever, chest pain, and difficulty breathing.

Aspergillosis affecting the deeper tissues makes a person very ill. Symptoms include fever, chills, shock, delirium, and blood clots. The person may develop kidney failure, liver failure (causing jaundice), and breathing difficulties. Death can occur quickly.

Aspergillosis of the ear canal causes itching and occasionally pain. Fluid draining overnight from the ear may leave a stain on the pillow. Aspergillosis of the sinuses causes a feeling of congestion and sometimes pain or discharge.

In addition to the symptoms, an x-ray or computerised tomography (CT) scan of the infected area provides clues for making the diagnosis. Whenever possible, a doctor sends a sample of infected material to a laboratory to confirm identification of the fungus.

Diagnosis

On chest X-ray and computed tomography pulmonary aspergillosis classically manifests as an air crescent sign.

Treatment

The drugs amphotericin B, caspofungin, flucytosine, itraconazole, voriconazole are used to treat this fungal infection.

Notable Outbreaks

Aspergillosis has been the culprit in several recent rapid die-offs among waterfowl. From December 8-14, 2006 over 2,000 Mallards died in the Burley, Idaho area, an agricultural community approximately 150 miles southeast of Boise. Moldy waste grain from the farmland and feedlots in the area is the suspected source. A similar aspergillosis outbreak killed 500 mallards in Iowa in 2005. Moldy grain was the cause in that case.

Mallards and other ducks are particularly susceptible to Aspergillosis as they will often resort to poor food sources during bad weather.

Albeit relatively rare in humans, aspergillosis is a common and dangerous infection in birds, particularly in pet parrots and parakeets.

While there is no connection between Aspergillosis and the H5N1 strain of Avian Influenza (commonly called "bird flu"), the rapid die-offs it causes can spark fears of a bird-flu outbreak in the communities where the die-offs occur. There is no outwardly visible sign off the fungal infection as the cause; laboratory analysis is the only way to prove or disprove bird-flu or Aspergillosis.

External links

• Aspergillus - aspergillus.org.uk
• Aspergillosis -doctorfungus.org
• USGS National Wildlife Health Center - www.nwhc.usgs.gov

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