Aspergillus and Respiratory Infections

Aspergillus and Respiratory Infections

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Last edited and updated on: by Sagar Aryal

Aspergillus is a common fungus found in our environment. It has several types of the present in different regions of the world. They are extremely tolerant of high osmotic pressure (high salt, sugar concentration). They prefer to grow in an O2 abundant environment on carbon substrates as a mold. Starchy food substances regular colonizes by Aspergillus species and thus they cause loss to industrial products.

Aspergillus and Respiratory Infections

Morphology

Aspergillus is an abundant fungus found in our environment. It is thread-like fungus isolated from soil, indoor environment, dead plants, etc. they have distinct hyphae and conidia. Their hyphae are segmented and hyaline. They have a circular shape with threaded growth outwards and it’s named Aspergillus.

Species of Aspergillus

The significant species of Aspergillus genus are the following:

  1. Aspergillus niger
  2. Aspergillus flavus
  3. Aspergillus terreus
  4. Aspergillus fumigatus
  5. Aspergillus lentulus

Pathogenesis

Aspergillus usually considered harmless but the individuals with suppressed or enervate immune systems have a threat of developing an infection. They may cause mycotic keratitis, otomycosis, nasal sinusitis, and respiratory allergic reactions. The infection occurs after inhalation of spores generally called aspergillosis. There is a wide range of aspergillosis infections from an allergic reaction to an infection in different organs. The infection could be moderate to lethal.

Types of Aspergillosis

Aspergilloma

Formerly existing spaces in the lungs colonize by Aspergillus are known as aspergilloma due to entangling hyphae which form ball-like structure. It is regarded as a non-invasive infection. The disease can establish into 15% – 20% of patients having cavities in the lungs. The symptoms of disease initially slight coughing but under severe conditions wheezing, fatigue, shortness of breath, weight loss and hemoptysis occurs.

Allergic bronchopulmonary  aspergillosis

Aspergillus colonize membranous lining of lungs in individuals having asthma, cystic fibrosis to a critical level. The symptoms include coughing, aggravating asthma, cough with mucus, or blood.

Invasive Aspergillosis

It is the rarest and severe case of Aspergillus infection which begins to disseminating all over the body. This infection results in the case of transplantation, chemotherapy, or autoimmune disorders. If the infection is not treated timely it is lethal for a person.

Chronic necrotizing pulmonary aspergillosis

It is an enduring respiratory infection that occurs in immune-compromised or immunocompetent patients having respiratory problems. The sign and symptoms are fever, weight loss, cough, and night sweats.

Superficial aspergillosis

This is an unusual infection that occurs due to injury, burns, eye damage, sinuses, or ear canal infection by Aspergillus species.

Diagnosis

The aspergillosis interpreted by manifestations in patients and hints were provided by X-ray or computed tomography. And for recognizing species of fungus sample is sent to the laboratory for culturing. And sometimes sample collected via biopsy.

Treatment

The treatment of infection could be antifungal drugs, surgery for removing fungus from the body.

Aspergilloma

Treatment preferred when symptoms begin showing especially hemoptysis. Surgical removal is applicable but difficult due to restricted breathing functions. Amphotericin B gave to some patients but it fails to affect them.

Allergic bronchopulmonary aspergillosis

The goal of curing allergic bronchopulmonary aspergillosis (ABPA) is restricting establishing infection in the lungs. The major cure is oral corticosteroids which reduce inflammation and hypersensitive actions.

Invasive aspergillosis

For curing invasive aspergillosis antifungal drugs voriconazole allowed for initial therapy. While triazoles prevent formation of ergosterol of fungal cell membrane. The orally available drug is posaconazole with a wide spectrum and similar in structure with itraconazole. Sometimes amphotericin was suggested for curing an infection.

Chronic necrotizing pulmonary aspergillosis

Antifungal treatment provided for this and initially Amphotericin B (0.5–1 mg−1·kg−1·day−1) with beneficial results. And for the late stages itraconazole is an effective choice. Surgical removal is chosen for those having localized diseased with good pulmonary function and not bearing antifungal therapy.

References

  1. https://en.wikipedia.org/wiki/Aspergillus
  2. https://drfungus.org/knowledge-base/aspergillus-species/
  3. https://microbewiki.kenyon.edu/index.php/Aspergillus
  4. https://www.aspergillus.org.uk/content/medically-important-species-aspergillus
  5. https://www.pjms.com.pk/issues/octdec207/article/article9.html
  6. https://www.cdc.gov/fungal/diseases/aspergillosis/index.html
  7. https://www.sciencedirect.com/topics/medicine-and-dentistry/aspergilloma
  8. https://www.mayoclinic.org/diseases-conditions/aspergillosis/symptoms-causes/syc-20369619
  9. https://www.merckmanuals.com/home/infections/fungal-infections/aspergillosis
  10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5440998/
  11. https://www.mayoclinic.org/diseases-conditions/aspergillosis/symptoms-causes/syc-20369619
  12. https://emedicine.medscape.com/article/296052-treatment
  13. https://err.ersjournals.com/content/20/121/156#sec-10
  14. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4200583/
  15. https://err.ersjournals.com/content/20/121/156#sec-6
  16. https://err.ersjournals.com/content/20/121/156#sec-14
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