Aspergillosis infectious disease
- On 09/02/2026
What is Aspergillosis?
Invasive infections usually occur after the inhalation of spores by the at-risk patient or, more rarely, thru direct invasion at the site of skin lesions.
The major risk factors for aspergillosis are:
- Neutropenia when prolonged (typically > 7 days)
- Long-term high-dose corticosteroid therapy
- Organ transplantation (particularly bone marrow transplantation with graft-versus-host disease, GVHD)
- Hereditary neutrophil function disorders (e.g., chronic granulomatous disease)
Aspergillus spp tends to infect open spaces, such as pulmonary cavities resulting from a previous lung disorder (e.g., bronchiectasis, tumor, tuberculosis), the sinuses, or the external ear canals (otomycosis). These infections tend to be locally invasive and destructive, although systemic dissemination is sometimes observed, particularly in immunocompromised patients who have neutropenia or immunosuppression due to corticosteroid use. Aspergillosis can also occur in cases of HIV/AIDS infection.
A. fumigatus is the most frequent cause of invasive pulmonary disease.
Allergic bronchopulmonary aspergillosis is a hypersensitivity reaction to A. fumigatus that triggers lung inflammation not related to fungal tissue infection.
Focal infections are usually found in the lungs and sometimes form a fungal ball (aspergilloma), a characteristic mass made up of filaments (or hyphae), with fibrinous exudate and few inflammatory cells, usually surrounded by fibrous tissue. There is sometimes a certain local invasion of the tissues at the periphery of the cavity, but usually, the fungus resides only in the cavity without any observable local invasion.
A chronic form of invasive aspergillosis is sometimes observed, particularly when corticosteroids are administered long-term and in cases of chronic granulomatosis, which is characterized by a hereditary phagocyte cell defect.
Aspergillus spp can also cause endophthalmitis after trauma or surgical intervention on the eye, or thru hematogenous seeding and infections of intravascular and intracardiac prostheses.
Primary superficial aspergillosis is rare but can occur on burns; under occlusive dressings; after a corneal injury (keratitis); in the sinuses, mouth, nose, or ear canal.
Causes
Aspergillosis is caused by the inhalation of spores from the Aspergillus fungus, primarily:
- Aspergillus fumigatus
- Aspergillus flavus
- Aspergillus niger
The spores enter the lungs thru breathing.
Other risk factors
- Weakened immune system (HIV, cancer, chemotherapy)
- Organ transplant
- Poorly controlled diabetes
- Old tuberculosis
- Severe asthma
- Prolonged use of corticosteroids
- Prolonged hospitalization
Symptoms
The symptoms vary depending on the form:
Respiratory symptoms
Persistent cough
Shortness of breath
Chest pain
Coughing up blood (hemoptysis)
General symptoms
Fever
Intense fatigue
Weight loss
Nite sweats
Severe symptoms (invasive form)
Respiratory distress
Neurological disorders
Organ failure
What are the prevention methods to avoid infection?
- Avoid very dusty environments
- Wear a mask in high-risk areas
- Properly store food
- Treatment and monitoring of lung diseases
- Strengthening immunity (nutrition, medical follow-up)
Possible medical treatments for curing Aspergillosis
The treatment depends on the form and severity:
Medical treatment
- Antifungals: voriconazole, itraconazole, amphotericin B
- Corticosteroids (in allergic forms)
- Antibiotics if associated infection
Surgical treatment
- Ablation of an aspergilloma in case of significant bleeding
Medical follow-up
Treatment often lengthy
Regular monitoring thru imaging and tests