Aspergillus Pneumonia
Overview
This is a rare form of aspergillosis, affecting people with a normal immune system. Only a few cases have been reported, usually after a severe environmental exposure eg while exposed to mouldy hay, tree-bark chippings, dust in an occupational setting and in one case, after near drowning! Exposure can be short – a single incident.
Symptoms
Signs and symptoms can include:
- Fever (38C+)
- Shortness of breath
- Wheezing
- Rapid, shallow breathing
- Cough, which may produce mucous
- Chest pain that gets worse as inhale deeply
Diagnosis
Diagnosing Aspergillus pneumonia can be difficult as signs and symptoms can be mistaken for extrinsic allergic alveolitis and that can lead to treatment with corticosteroids, which is inappropriate for pneumonia and can lead to worsening of the condition. Therefore, a range of specialist tests are conducted to reach a definitive diagnosis.
Causes
Aspergillus pneumonia causes clearly relate to a sudden exposure to a large number of fungal spores. We can speculate that this may overwhelm the immune systems response in some patients but this is not well researched. We are also beginning to see cases relating to people who live in damp, mouldy homes but the connection between the mouldy in the home and the mould in the patients airways is poorly established. In a recent case in Manchester Aspergillus pneumonia was given as cause of death but very low levels of Aspergillus were detected in the home (See article in the Manchester Evening News).
For a recent review on all forms of aspergillosis including Aspergillus pneumonia: The clinical spectrum of pulmonary aspergillosis, Kosmidis & Denning, Thorax 70 (3) Free download
Treatment
Invasive aspergillosis requires hospitalisation and treatment with intravenous antifungal medications. Untreated, this form of aspergillosis may be fatal.