Clinical manifestations of Aspergillus infection of the lungs(Pulmonary aspergillosis)

There are four common manifestations of pulmonary aspergillosis namely - Allergic Broncho Pulmonary Aspergillosis (ABPA), Chronic Necrotizing Pulmonary Aspergillosis(CNPA), aspergilloma ('Fungal ball') and invasive aspergillosis.

 

1) ABPA - is almost exclusively seen in asthmatics or cystic fibrosis patients. It is basically an allergic reaction to aspergillus that is colonized in the airways. Patients have fever and respiratory symptoms (cough, hemoptysis, wheezing).

2) Aspergilloma -  is seen in immunocompromised patients. or in lungs with pre-existing cavities.  Aspergillomas are often silent or cause fever and respiratory symptoms similar to ABPA.

 

3) CNPA - Occurs in individuals with underlying disease, such as severe chronic obstructive pulmonary disease (COPD) and prolonged antibiotic therapy. They present with symptoms  such as fever, cough, night sweats, and weight loss.

 

4) Invasive aspergillosis - occurs in patients with immunosuppression or ANC (Absoulute neutorphil count) and in patients post transplantation. These patients are usually sick and need urgent parenteral treatment.