As you know, there are millions of tiny organisms in the environment we live in, that is, in the air, soil, and plants. Some of these are fungi. The Aspergillus fumigatus that we are going to talk about today is one such fungus that is very common in our environment. For a healthy person with a good immune system, this fungus usually does not cause any harm even if it enters the body. Our body's defense system controls it. However, if a person's immune system is weakened due to a certain illness or medication, this fungus can cause dangerous infections.
Why is this fungus dangerous only for some people?
Simply put, this fungus is an opportunist. That is, it can't do anything as long as our body's defenses, or immune system, are strong. However, as soon as these defenses are weakened, it rears its head and starts causing problems.
What are the situations where immunity can be weakened?
- Weakening of the body due to reasons such as a serious illness, malnutrition, or aging.
- Immunosuppression due to certain diseases (for example, AIDS) or medications (for example, cancer treatments, medications given after organ transplants).
- Implantation of prosthetic devices.
- Conditions such as prolonged neutropenia.
If someone in such a vulnerable situation becomes infected with this fungus, it can even be life-threatening.
How this fungal infection (Aspergillosis) develops and its symptoms
The spores of this fungus enter the body with the air we breathe. They first reach the nose, throat, sinus cavities, and lungs. The immune cells of a healthy person do not allow them to grow. But in the body of a person with a weak immune system, these spores germinate, grow into fungal hyphae, and begin to invade tissues, cause blood clots (thrombosis), and cause allergies.
There are several conditions caused by this infection. Symptoms depend on the organ that is infected and your immune system.
| Medical condition | A simple explanation |
|---|---|
| Chronic Pulmonary Aspergillosis (CPA) | In this case, the fungus grows slowly inside the lungs. Symptoms may not appear for months, sometimes even years. The main symptom is a cough. In addition, weight loss, fatigue, and difficulty breathing may occur. Most importantly, if this fungus damages a blood vessel in the lungs, coughing up blood (hemoptysis) can occur. This is a very dangerous symptom. If this happens, you should immediately go to a hospital or emergency room (ETU). |
| Invasive Aspergillosis | This is the most dangerous and potentially life-threatening condition. It occurs in people with very weak immune systems. The fungus can grow very quickly and spread to the lungs, sinuses, ears, skin, eyes, and even the brain. |
| Aspergilloma | This is like a "fungal ball" that forms inside a cavity in the lungs. There are usually no symptoms. However, if this fungal ball grows large and damages a blood vessel, you may cough up blood. |
| Fungal Sinusitis | It occurs when fungal spores enter and grow in the sinus cavities. Symptoms include nasal congestion, difficulty breathing, facial pain, headache, and thick, green, or black mucus. |
Important: This fungus usually does not cause problems for a healthy person. There is no need to panic. This information is for informational purposes only. If you are in doubt about any symptoms, consult your doctor.
Allergy to fungus
Sometimes this fungus can cause allergies rather than invasive infections. These are usually not life-threatening, but can cause illness.
The most common of these is Allergic Bronchopulmonary Aspergillosis (ABPA) . This is most common in people with pre-existing lung disease. For example, people with conditions such as asthma, cystic fibrosis, or bronchiectasis are at higher risk.
This is when the body overreacts to fungal spores that enter through breathing. This causes symptoms similar to asthma, such as wheezing, coughing, and difficulty breathing.
Your doctor will order some tests to find out if you have ABPA.
- Tests to check for elevated levels of a type of white blood cell called eosinophils in the blood.
- Skin tests for Aspergillus antigen.
- Testing blood levels of Aspergillus antibodies and IgE.
- Chest X-ray.
What are the treatment options?
Treating this fungal infection is a bit complicated. It definitely requires the advice of a doctor. Never try to treat it on your own.
- Antifungal drugs: Depending on the type and severity of the infection, your doctor may prescribe medications such as amphotericin B and voriconazole. These treatments may need to be taken for several weeks or longer.
- Surgery: Large fungal balls (aspergillomas) that form in the lungs are not treated with medication alone. They need to be removed surgically. Also, in cases of fungal sinusitis, it may be necessary to surgically clean the sinus cavities and allow the fluid to drain.
- Allergy treatment: If you have an allergic condition like ABPA, the main treatment is to give steroids (e.g. prednisolone). These control the body's over-reaction. Sometimes antifungal medications are also given to reduce the dose of steroids and minimize side effects.
Drug resistance
Unfortunately, sometimes this fungus becomes resistant to the antifungal drugs we use, especially the azoles. This makes treatment even more complicated. Therefore, it is very important to take the medication exactly as prescribed by your doctor, and for the right amount of time.
Take-Home Message
- Aspergillus fumigatus is a very common fungus in our environment. It usually does not cause harm to healthy people.
- This fungus can cause dangerous infections in people with weakened immune systems (e.g., cancer patients, organ transplant recipients, AIDS patients).
- If you have symptoms such as a persistent cough, shortness of breath, weight loss, fatigue, and especially coughing up blood, see your doctor immediately.
- The treatment method is determined by the type of disease and your health condition. For this, you should definitely seek medical advice.
- People with lung diseases such as asthma may be allergic to this fungus, so inform your doctor if your symptoms worsen.
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