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| Aspergillosis, Definition, Symptoms, Causes, Diagnosis, Treatment, Prevention, Complications |
Aspergillosis is an infectious disease caused by the fungus Aspergillus. This fungal infection generally affects the respiratory system, but it can also spread to other parts of the body, such as the skin, eyes, or brain.
Aspergillus fungus lives in soil, trees, rice, dry leaves, compost, air conditioners and heaters, or in damp places. If inhaled, the fungus can cause infection. However, Aspergillus fungal infections are more common in people with weak immune systems.
Causes of Aspergillosis
Aspergillosis occurs when Aspergillus fungal spores are inhaled into the respiratory tract. There are many types of Aspergillus fungus, but the most common cause of aspergillosis is Aspergillus fumigatus (A. fumigatus).
In general, there are several factors that can increase a person's risk of developing aspergillosis, namely:
- Having a weak immune system due to suffering from HIV/AIDS or blood cancer, using immunosuppressant drugs or corticosteroids, and undergoing chemotherapy
- Undergoing an organ transplant or bone marrow transplant
- Have a lung disease, such as asthma, COPD, tuberculosis (TB), sarcoidosis, or cystic fibrosis
Aspergillosis is not contagious, neither between humans nor from animals to humans.
Symptoms of Aspergillosis
In people with good immune systems, inhaled Aspergillus spores will not cause complaints. On the other hand, in people who have a weak immune system or have the risk factors mentioned above, inhalation of Aspergillus spores can cause various symptoms.
Symptoms and complaints that appear depend on the organs or body tissues that are attacked by Aspergillus fungal spores. The following are the types of health problems due to aspergillosis and the accompanying symptoms:
Allergic bronchopulmonary aspergillosis (ABPA)
ABPA is most common in people with asthma or cystic fibrosis. This condition is an allergic reaction due to exposure to Aspergillus fungus spores. Complaints similar to asthma symptoms, namely wheezing, difficulty breathing, shortness of breath, and weakness.
Aspergilloma
Chronic lung diseases, such as emphysema and tuberculosis can cause cavities to form in the lungs. If the patient is infected with Aspergillus fungal spores, then this fungus can grow and fill the lung cavities. This condition is called aspergilloma.
Aspergilloma can make the condition of people with chronic lung disease worse and cause a number of complaints, such as:
- Hard to breathe
- Coughing up blood (hemoptysis)
- Wheezing
- Tired easily
- Weight loss
Invasive pulmonary aspergillosis (IPA)
Invasive pulmonary aspergillosis or IPA usually occurs in people with weak immune systems, for example in people with HIV, people undergoing chemotherapy, or recently undergoing a bone marrow transplant.
IPA is the most severe type of aspergillosis, because this infection can spread to the skin, kidneys, lungs, and brain. Symptoms that arise in this type depend on the organ affected. However, in general, the symptoms of IPA include:
- Fever and chills
- Bleeding cough
- Chest pain
- Hard to breathe
- Headache
When to go to the doctor
Check with your doctor if you experience the symptoms of aspergillosis as previously mentioned. You are also advised to seek medical attention immediately if there is a family suffering from asthma or cystic fibrosis and experiencing symptoms of aspergillosis.
Immediately seek medical attention to the emergency room at the nearest hospital if you experience complaints in the form of fever, coughing up blood, and shortness of breath. This condition can be a sign that you have invasive aspergillosis that must be treated immediately.
Aspergillosis diagnosis
The doctor will ask questions related to the patient's complaints and medical history, followed by a physical examination to hear the patient's breath sounds.
Aspergillosis is difficult to diagnose because its symptoms can be similar to those of other respiratory disorders, such as tuberculosis. Therefore, to confirm the diagnosis, the doctor will perform the following investigations:
- Scanning with X-rays or CT scans, to look for the presence of aspergilloma, as well as see signs of infection in the lungs
- Sputum test, to check for the presence of Aspergillus or other microorganisms that can cause infection
- Blood test, to measure antibody levels in the blood as a sign of an allergic reaction and to detect signs of infection
- Bronchoscopy, to examine the condition of the lungs as well as take a tissue sample (biopsy) for further investigation
Aspergillosis Treatment
Treatment for aspergillosis can vary, depending on the severity and type of aspergillosis you have. Some of the methods of treatment that can be done by doctors are:
- Observation, to monitor the condition of patients with mild symptoms or in patients with aspergillosis who have aspergilloma
- Administration of antifungal drugs, such as voriconazole or amphotericin B, especially for patients with IPA
- Administration of corticosteroids and antifungal drugs for several months, to treat the symptoms of ABPA
- Administration of oral corticosteroid drugs, to prevent the patient's asthma or cystic fibrosis from getting worse
- Surgery, to remove the aspergilloma, especially if the aspergilloma is causing bleeding in the lungs
- Embolization, to stop bleeding caused by aspergilloma
Complications of Aspergillosis
Depending on the type suffered, aspergillosis can cause a number of complications, namely:
- Widespread infection (sepsis) that spreads rapidly to other parts of the body, such as the brain, heart, and kidneys
- Severe bleeding in the lungs, especially in patients with aspergilloma and IPA
- Atelectasis
- Asthma getting worse
- Bronchiectasis and pulmonary fibrosis
Aspergillosis Prevention
Aspergillosis is difficult to prevent because the fungal spores that cause this condition are easily inhaled. However, there are several ways that can be done to reduce the risk of aspergillosis, especially for people with weak immune systems. Some of these ways are:
- Avoid places that are prone to mold growth, such as excavations, rice or wheat storage areas, and compost piles
- Wearing a mask and covered clothing when doing activities in places where there is a risk of fungal exposure, such as in gardens, rice fields, or forests
- Wearing gloves when doing activities that require direct contact with soil, feces, or moss
- Undergo control and regular treatment if you suffer from an illness or are on drug therapy that can weaken your immune system
- Do not dry wet clothes in the house, especially in the bedroom
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