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| __NOTOC__
| | #redirect [[Aspergillosis]] |
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| ==Overview==
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| '''[[Aspergillosis]]''' is an [[infection]] caused by the fungus [[Aspergillus]]. Aspergillosis describes a large number of diseases involving both infection and growth of [[fungus]] as well as [[Allergy|allergic responses]]. Aspergillosis can occur in a variety of organs, both in humans and animals.
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| The most common sites of infection are the respiratory apparatus ([[lung]]s, [[sinuses]]) and these infections can be:
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| *Invasive (e.g. <ref>Invasive Pulmonary Aspergillosis</ref> - IPA)<ref>[http://www.aspergillus.org.uk/aspergillosis.htm]</ref>
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| *Non-invasive (e.g. [[Allergic bronchopulmonary aspergillosis|Allergic Pulmonary Aspergillosis]] - ABPA)<ref>[http://www.aspergillus.org.uk/abpa.htm]</ref>
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| *Chronic pulmonary and aspergilloma (e.g. chronic cavitary, semi-invasive)<ref>[http://www.aspergillus.org.uk/aspergilloma.htm]</ref>
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| *Severe [[asthma]] with fungal sensitisation (SAFS)<ref>[http://www.aspergillus.org.uk/safs.htm]</ref>
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| Chronic pulmonary aspergillosis - CPA is a long-term aspergillus infection of the lung and [[Aspergillus fumigatus]] is almost always the species responsible for this illness. Patients fall into several groups as listed below.
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| *Those with an aspergilloma<ref>{{cite journal|last=Judson|first=MA|author2=Stevens, DA |title=The treatment of pulmonary aspergilloma.|journal=Current opinion in investigational drugs (London, England : 2000)|date=Oct 2001|volume=2|issue=10|pages=1375–7|pmid=11890350}}</ref> which is a [[Fungal ball|ball of fungus]] found in a single lung cavity - which may improve or disappear, or change very little over a few years.
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| *Aspergillus nodule <ref>{{cite journal|last=Baxter|first=CG|author2=Bishop, P |author3=Low, SE |author4=Baiden-Amissah, K |author5= Denning, DW |title=Pulmonary aspergillosis: an alternative diagnosis to lung cancer after positive [18F]FDG positron emission tomography.|journal=Thorax|date=Jul 2011|volume=66|issue=7|pages=638–40|pmid=21460371 |doi=10.1136/thx.2010.155515}}</ref>
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| *Chronic cavitary pulmonary aspergillosis (CCPA)<ref>{{cite journal|last=Denning|first=DW|author2=Riniotis, K |author3=Dobrashian, R |author4= Sambatakou, H |title=Chronic cavitary and fibrosing pulmonary and pleural aspergillosis: case series, proposed nomenclature change, and review.|journal=Clinical infectious diseases : an official publication of the Infectious Diseases Society of America|date=Oct 1, 2003|volume=37 Suppl 3|pages=S265-80|pmid=12975754 |doi=10.1086/376526}}</ref> where cavities are present in the lungs, but not necessarily with a fungal ball (aspergilloma).
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| *Chronic fibrosing pulmonary aspergillosis <ref>{{cite journal|last=Denning|first=DW|author2=Riniotis, K |author3=Dobrashian, R |author4= Sambatakou, H |title=Chronic cavitary and fibrosing pulmonary and pleural aspergillosis: case series, proposed nomenclature change, and review.|journal=Clinical infectious diseases : an official publication of the Infectious Diseases Society of America|date=Oct 1, 2003|volume=37 Suppl 3|pages=S265-80|pmid=12975754 |doi=10.1086/376526}}</ref> this may develop where pulmonary aspergillosis remains untreated and chronic [[scarring]] of the lungs occurs. Unfortunately scarring of the lungs does not improve.
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| Most patients with CPA have or have had an underlying [[lung disease]]. The most common diseases include [[tuberculosis]], [[atypical mycobacterium infection]], stage III fibrocystic [[pulmonary sarcoidosis]], ABPA, [[lung cancer]], [[Chronic obstructive pulmonary disease|COPD]] and [[emphysema]], asthma and [[silicosis]].
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| == Diagnosis ==
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| The specific criteria for diagnosis of CPA are:
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| Chest X-rays showing one or more lung cavities. There may be a fungal ball present or not.
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| Symptoms lasting more than 3 months, usually including [[weight loss]], [[Fatigue (medical)|fatigue]], [[cough]], coughing blood ([[haemoptysis]]) and [[breathlessness]]
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| A [[blood test]] or [[tissue fluid]] test positive for Aspergillus species
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| Aspergilloma
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| An aspergilloma is a fungal mass caused by a [[Fungal infection in animals|fungal infection]] with Aspergillus species that grows in either scarred lungs or in a pre-existing lung cavity, which may have been caused by a previous infection. Patients with a previous history of [http://www.healthline.com/galecontent/tuberculosis-4 tuberculosis], [[sarcoidosis]], [[cystic fibrosis]] or other lung disease are most susceptible to an aspergilloma. Aspergillomas may have no specific symptoms but in many patients there is some coughing up of blood called haemoptysis - this may be infrequent and in small quantity, but can be severe and then it requires urgent medical help.
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| Tests used to diagnose an aspergilloma may include:
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| === Chest X-ray ===
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| [http://www.healthline.com/adamcontent/chest-tomogram Chest CT]
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| [[Sputum culture]]
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| [[Bronchoscopy]] or bronchoscopy with lavage (BAL)
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| Serum [[precipitin]]s for aspergillus (blood test to detect antibodies to aspergillus)
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| Almost all aspergillomas are caused by Aspergillus fumigatus. In [[diabetic]] patients it may be caused by [[Aspergillus niger]]. It is very rarely caused by [[Aspergillus flavus]], [[Aspergillus oryzae]], [[Aspergillus terreus]] or [[Aspergillus nidulans]].
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| == Treatment ==
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| Patients with single aspergillomas generally do well with [[surgery]] to remove the aspergilloma, and are best given pre-and post-operative [[Antifungal medication|antifungal drugs]]. Often, no treatment is necessary. However, if a patient coughs up blood (haemoptysis), treatment may be required (usually [[angiography]] and [[embolisation]], surgery or taking [[tranexamic acid]]). Angiography (injection of dye into the blood vessels) may be used to find the site of bleeding which may be stopped by shooting tiny pellets into the bleeding vessel.
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| For more complex, chronic cases, lifelong use of antifungal drugs is usual, along with chest X-rays to monitor progress. It is important to monitor the blood levels of antifungals to ensure optimal dosing as individuals vary in their absorption levels of these drugs.
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| There are however homeopathic alternative medicines that are available as a treatment for this ailment. the increased dosage of magnesium has been purported to remove the fungal infection without surrgery over time. <ref>http://www.thoracic.org/statements/resources/tb-opi/treatment-of-fungal-infections-in-adult-pulmonary-critical-care-and-sleep-medicine.pdf</ref><ref>http://www.raysahelian.com/nailfungus.html</ref><ref>http://drcarolyndean.com/2013/06/magnesium-deficiency-yeast-overgrowth/</ref><ref>http://www.ncbi.nlm.nih.gov/pubmed/7632171</ref><ref>http://drcarolyndean.com/2013/06/magnesium-deficiency-yeast-overgrowth/</ref>
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| ==References==
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| {{reflist|2}}
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| [[Category:Fungal diseases]]
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