What is invasive aspergillosis? — Invasive aspergillosis is a condition that can cause fever, cough, and other symptoms. It is caused by infection with a fungus called "aspergillus."
Invasive aspergillosis usually only happens in people who have conditions that weaken the body's infection-fighting system. This system is called the "immune system." These conditions include:
Neutropenia – This condition happens when you do not have enough of a type of white blood cell called "neutrophils." Neutrophils help your body fight infections. Getting treatment for certain diseases, such as some types of cancer, causes neutropenia. Some diseases can also cause it.
A bone marrow transplant (also called a "hematopoietic cell transplant" or "stem cell transplant") – The risk of invasive aspergillosis is higher when:
•People get medicines before a transplant to get the body ready. These medicines cause neutropenia.
•Some people take high doses of steroid medicines after a transplant. Doctors give these medicines if the transplant is attacking the person's own cells. This is called "graft versus host disease" or "GVHD." The steroid medicines that treat GVHD can make it hard for the body to fight infection.
An organ transplant – This can include a heart, lung, or liver transplant. The medicines you take to keep the transplant healthy make you more likely to get infections.
Taking high doses of steroid medicines – These are not the same as the steroids some athletes take illegally. Doctors give these steroids to treat certain diseases. People who have an organ transplant usually have to take steroids. But people with other conditions sometimes do, too.
Invasive aspergillosis usually affects the lungs. But it can also get into the bloodstream and spread to other organs. These include the heart, brain, and digestive system. Invasive aspergillosis is a serious infection. It can even cause death.
What are the symptoms of invasive aspergillosis? — Symptoms in the lungs can include:
Chest pain – This can be a sharp, stabbing pain that gets worse when you breathe in.
Being short of breath – You might feel like you cannot get enough air or have to work harder than usual to breathe.
Cough – Some people cough up mucus or blood.
Symptoms in other parts of the body can include:
Stuffy nose, fever, and pain in the face
Eye pain, vision problems, or bulging or swollen eyes
Seizures – These are jerking or twitching movements a person cannot control.
Rash with spots – The center of the spots might be black.
Will I need tests? — Yes. Your doctor or nurse will do an exam and learn about your symptoms. He or she will also do tests to look for signs of the fungus that causes invasive aspergillosis. These can include:
Tests on a sample of mucus that you cough up
CT scan – This imaging test uses a special X-ray to create pictures of the inside of the body.
MRI scan – This imaging test uses powerful magnets to create pictures of the inside of the body. Invasive aspergillosis sometimes spreads to the brain. Your doctor can order this test to check if he or she thinks this is likely.
Bronchoscopy – In this test, a doctor uses a thin tube with a camera on the end (called a "bronchoscope") to look inside the lungs. He or she can take samples of fluid and sometimes tissue from the lungs. Another doctor will look at the tissue samples for signs of invasive aspergillosis. The samples are also placed in a "culture" to see if the fungus grows. You might have this test if other tests do not show for sure that you have aspergillosis.
How is invasive aspergillosis treated? — Treatments include:
Medicines to kill the fungus that causes aspergillosis – These medicines are called "antifungals." They are often given through a thin tube that goes into a vein, called an "IV." Some people can take pills by mouth.
Taking less of any medicines that make it hard for the immune system to work correctly – You can do this if your doctor thinks this is safe.
Doing surgery to take out infected or dead tissue – Doctors sometimes need to do this if aspergillosis affects the sinuses. The sinuses are hollow areas in the bones of the face.
Depending on your situation, you might take medicines to treat the fungus for several months or even years.
Can invasive aspergillosis be prevented? — Sometimes. If you have a high risk of getting invasive aspergillosis, your doctor might give you an antifungal medicine to help prevent it. But the medicines can cause side effects or lead to infection with fungi that are resistant to the antifungal medicine, so they might not be appropriate for you unless you are at high risk.
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 83434 Version 12.0
Release: 28.2.2 - C28.105
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