Aspergillus Bronchitis

Aspergillus bronchitis (AB) is a chronic illness where the Aspergillus fungus causes an infection in the large airways (bronchi). Aspergillus spores are found everywhere but you might breathe in particularly large amounts if you have mould in your home, or spend a lot of time gardening. People with abnormal airways (e.g. in cystic fibrosis or bronchiectasis) have a higher risk of getting Aspergillus bronchitis after breathing in the fungus. It also affects people who have a slightly weakened immune system, which can be caused by other medications you take — such as steroid inhalers. It cannot be passed on from one person to another; you cannot give the disease to other people. Unlike allergic bronchopulmonary aspergillosis (ABPA), there is no allergic response with Aspergillus bronchitis. Patients with chronic pulmonary symptoms and evidence of Aspergillus in the airways, but who do not fulfil the diagnostic criteria for chronic pulmonary aspergillosis (CPA), allergic bronchopulmonary aspergillosis (ABPA)  or invasive aspergillosis (IA), may have AB.

Symptoms

People often have a long-lasting chest infection that does not improve with antibiotics before they find that they have Aspergillus bronchitis.

Diagnosis

Risk factors for different types of fungal disease, including CPA, ABPA, Invasive Aspergillosis and Aspergillus Bronchitis

To be diagnosed with Aspergillus bronchitis you must have:

  • Symptoms of a lower airway disease for over one month
  • Phlegm containing the Aspergillus fungus
  • A slightly weakened immune system

The following are also suggestive that you have Aspergillus bronchitis:

  • High levels of a marker for Aspergillus in your blood (called IgG)
  • A white film of fungus coating your airways, or plugs of mucus seen on a camera test (bronchoscopy) if performed
  • A good response to antifungal medication after eight weeks of treatment

The Aspergillus fungus causes different illnesses, so it can be hard to know where Aspergillus bronchitis fits into the larger picture. The table on the right shows factors that increase your risk of having one of these illnesses:

Treatment

The antifungal medicine, itraconazole (Originally Sporanox® but now several other tradenames), may keep Aspergillus bronchitis under control. Your symptoms should start improving after taking itraconazole for four weeks. People taking itraconazole need to have their blood pressure taken, as well as having regular blood tests. These are to check that you are on the right dose and that enough of the medicine is getting into your blood. Some people may need other medicines which their doctor will discuss with them individually. A physiotherapist can also teach you exercises to make it easier to clear phlegm from your lungs, which can help improve your breathing. It is also very important to continue taking other medications to control other health problems that you have.

Further information: