Invasive aspergillosis is caused by filamentous fungi of the Aspergillus species, which are found ubiquitously in soil. Inhalation of the aerosolized conidia (spores) causes the infection.
Mostly affects immunocompromised patients (e.g., stem cell transplant recipients, prolonged severe neutropenia, immunosuppressive therapy). It is rare in immunocompetent hosts.
Clinical findings are nonspecific and include fever, cough, and pleuritic pain. High index of suspicion is required for early diagnosis. Lungs, sinuses, brain, and skin are sites of involvement.
High-resolution CT scan and serum Aspergillus galactomannan antigen test are useful tests for early diagnosis.
Voriconazole is the antifungal agent of choice; an alternate drug is the lipid formulations of amphotericin B.
Early diagnosis and therapy significantly improve prognosis of patients with invasive aspergillosis.
Aspergilloma forms in preformed lung cavities. It is usually asymptomatic. Diagnosis is generally made by CXR or CT scan. Antifungal drugs have been shown not to be beneficial. Surgery may be required in patients with severe hemoptysis.
Morphology of conidiophores and conidia of Aspergillus fumigatus
From the collection of Dr P. Chandrasekar