Patient handout for A&E staff who are not aware of aspergillosis.
What is CPA?
CPA is a chronic fungal infection of the lungs caused by Aspergillus, most often in people who already have damaged lungs from conditions like tuberculosis, COPD, lung cancer, or sarcoidosis.
Unlike ABPA, CPA is a true infection, not an allergic reaction. It is not contagious but can slowly destroy lung tissue if not treated.
Symptoms
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Chronic cough, often with mucus
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Coughing up blood (haemoptysis)
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Fatigue, low-grade fever
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Unexplained weight loss
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Breathlessness
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Recurrent chest infections not responding to antibiotics
Diagnosis
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CT scan of the chest showing cavities, nodules, or fungus balls (aspergillomas)
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Aspergillus IgG antibody (usually raised)
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Positive sputum PCR or culture for Aspergillus
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Exclude TB and malignancy
Treatment
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Long-term antifungal therapy (e.g. itraconazole, voriconazole, posaconazole)
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Monitor blood levels and liver function
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Surgery or embolisation if severe bleeding occurs
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Supportive care: oxygen, nutrition, physiotherapy
Key Points for A&E:
✅ CPA is a progressive fungal infection, not a typical bacterial pneumonia
✅ May present with haemoptysis, respiratory distress, or systemic illness
✅ Review current antifungal treatment and potential drug interactions
✅ Consider urgent chest CT and specialist referral if patient is unwell
📍 For specialist support:
National Aspergillosis Centre (NAC)
🏥 Wythenshawe Hospital, Manchester University NHS Foundation Trust
🌐 NAC homepage on MFT website https://mft.nhs.uk/wythenshawe/services/infectious-diseases/national-aspergillosis-centre/
🌐 www.aspergillosis.org
📞 Daytime contact: 0161 291 2891 or 0161 291 4362
📞 Urgent out-of-hours: Call Wythenshawe switchboard on 0161 998 7070
📢 Ask for the on-call Infectious Diseases Consultant
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