ASPERGILLOSIS IN ENGLISH

                                                     

                                            ASPERGILLOSIS IN ENGLISH

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ASPERGILLOSIS-

Ø  Aspergillosis is a fungal disease that may show a variety of clinical syndromes produced by several of the Aspergillus species. Such as-

Ø  Allergic broncho-pulmonary aspergillosis,

Ø   Aspergilloma,

Ø  Acute aspergillus sinusitis etc.

Ø  Allergic broncho-pulmonary aspergillosis-   Allergic bronchopulmonary aspergillosis having symptoms similar to asthma, is an allergy to the spores of Aspergillus moulds. Up to 5% of adult asthmatics may develop it at some time during their lives; it is also common in cystic fibrosis patients reaching adolescence and adulthood.

Ø  In the long term, allergic broncho-pulmonary aspergillosis can lead to permanent lung damage (fibrosis) if untreated.  Evidences suggest that fungal allergy is associated with increasing severity of asthma.

Ø  Diagnostic investigations- Diagnostic investigations of allergic broncho-pulmonary aspergillosis includes X-ray , by sputum examination, positive Aspergillus skin-prick testing, the detection of elevated IgE (1000 IU/mL) or positive Aspergillus precipitins

Ø   Aspergilloma- Aspergilloma is also known as chronic cavitary pulmonary aspergillosis. it is caused by A. fumigatus and A. niger.

Ø  The fungus grows within a previously damaged cavity of the lung by  tuberculosis or sarcoidosis or other cavity-causing lung disease.

Ø  Symptoms may initially be absent but later symptoms may appear such as Weight loss, chronic cough, feeling rundown and tired. Hemoptysis can occur in up to 80% of affected people.

Ø  The diagnosis is made by X-rays, lung scans and Aspergillus precipitins testing.

Ø  Acute aspergillus sinusitis- Acute Aspergillus sinusitis (a form of invasive aspergillosis) may occur in cases of neutropenia or following a bone marrow/stem cell transplant.

Ø  Symptoms include fever, facial pain, nasal discharge and headaches etc.

Ø  Diagnosis is made by finding the fungus in sinus fluid or tissue and with scans

 

CAUSATIVE AGENTS-

Ø  there are about 40 aspergillus species which can causes   only 5 commonly causing invasive infection such as A. flavus, A. fumigatus, A. nidulaus, A. niger, and A. terreus.

Ø  Common allergenic species include A. fumigatus, A. clavatus and A. versicolor.

Ø  A. fumigatus causes most cases of fungus ball

TREATMENT-

Ø  Monitoring-

Ø  All aspergillosis do not need treatment. aspergillomas that don't cause symptoms may simply be closely monitored by chest X-ray. If the condition progresses, then antifungal medications may be recommended.

Ø  Anti-fungal drugs-

Ø  These drugs are the standard treatment mainly for invasive pulmonary aspergillosis. The most effective treatment is a newer antifungal drug, voriconazole. Amphotericin B is another option.

Ø  Corticosteroids-

Ø  The main aim in treating allergic bronchopulmonary aspergillosis is to prevent existing asthma or cystic fibrosis from worsening. The best way to attain this goal is the use of oral corticosteroids. 

Ø  Surgical management-

Ø  Antifungal medications don't penetrate an aspergilloma very well, surgery is the first-choice treatment to remove the fungal mass, when an aspergilloma causes bleeding in the lungs.

PREVENTION-

Ø  Use of HEPA mask- High efficiency particulate air (HEPA) filtered room air can decrease the incidence of invasive aspergillosis patients with profound and prolonged neutropenia.

Ø  Control and specific treatment of patients to reduce exposure.

Ø  General environmental cleanliness can also reduce chances of aspergillosis.