Jen W

My history with Aspergillosis begins about ten years ago in 2000, when I was living out in the Diablo Valley in Contra Costa, California. I began experiencing seasonal allergies to tree pollen.I can’t explain why these allergic spells began, when I had lived in the same area for a decade, but I suspect it may have been because I was under some emotional stress. Who knows. The allergic reactions resulted in severe coughing fits and coughing up plugs of mucus. The coughing fits would continue until they developed into pneumonia. The pneumonia was treated by several rounds of antibiotics. The pattern continued yearly until I moved out of the valley to the coast in the summer of 2009.

My new home came with a small weed-filled garden containing two overgrown fruit trees – an apple tree and a persimmon tree – which dropped fruit and leaves all autumn and into the rainy winter. One sunny Saturday in early 2010 I got out the rake and bin and began the clean-up. The next day I began coughing and developed the beginnings of pleuritic pain in my left lung. I had experienced short bouts (an hour or less) of pleuritic pain sporadically throughout my life so I was not unfamiliar with the symptom. However, I had never experienced sustained pleuritic pain like this. What began as a vague annoyance eventually developed to the point that it was affecting my daily life. I went to see my doctor and he ordered an x-ray and put me on antibiotics. My doctor consulted with the pulmonology department, and I was passed on to a critical care pulmonologist, who immediately ordered a CT scan and bronchoscopy. The CT scan revealed scarring in my left lung which probably caused by years of repeated pneumonias, and the result of the bronchoscopy revealed an acute case of two types of aspergillus infection, together with multiple bacterial infections. The pulmonologist consulted with the contagious disease specialists and ordered a battery of tests to try to figure out what underlying immune weakness could have resulted in this aspergillus infection. The test did not give any answers. I was placed on a 30 day treatment with two strong antibiotics and started a course of 400 mg/day of Itraconazole. I remained on the high dose of Itraconazole the rest of the year. Over time the pleuritic pain lessened, and subsequent x-rays and another bronchoscopy showed gradual improvement.

Early this year (2011) I again found myself picking up rotted fruit in the garden – and unfortunately without the face mask my doctor recommended I wear whenever I do garden cleanup. Big mistake. The next day I began feeling the pleuritic pain again, but this time on the right side. I emailed by doctor and described my symptoms. He was doubtful. It is highly unlikely, he said, that the aspergillus infection would crop up in another location. He ordered another x-ray and, sure enough, the right lung showed areas of occlusion. This time he ordered different blood tests looking for specific antigens to aspergillus, and other things I don’t remember. The results showed that I have antibodies to Aspergillus fumigatus. He suspects that I was exposed to a large amount of Aspergillus spores when I picked up the rotten fruit and leaves in the garden, and that I have developed a severe allergy to A. fumigatus (and also A. niger). I remained on high dose antifungal medication for several months until x-rays showed no further areas of occlusion in the lungs. My doctor then told me to go off the medication completely.

I wonder if this is a good idea given my experience the past three years. I wear a mask anytime I work in the garden, and take care not to expose myself to known sources of fungal spores such as compost, damp basements, etc. Although my doctor feels that my case is solved, anytime I feel run down or feel a cold coming on, I experience lung pain again. This is not giving me a lot of confidence that it is all over. I suspect I’ll be dealing with this fight with Aspergillus indefinitely.

Update 12/25/2013: Got myself to the ER last Sunday with ‘chest pain’ right in the center of my chest and referred pain up my left shoulder. At my age (53) and with a stressful job, I didn’t want to take the chance of assuming it was the lungs, when it could be a mild heart attack. But my heart is fine, and I have another pneumonia. The initial lab results turned up ‘rare mold growth’ and ‘refer to mycology’. Looking back at my medical records I realized I’ve been treated for pneumonia at least once a year since 2010 (when my records with Kaiser begin).

I realize most others here and on other support groups have much more serious conditions and live with severe health issues every day. I feel very fortunate that I feel healthy most of the time, and lead an active, athletic life. I do wonder though about the state of my lungs, and the reasons for the repeated lung infections. Is the mold living in my lungs and flaring up occasionally? Is it the house I live in? The doctors are baffled.