“What I Wish Every Doctor Knew About Aspergillosis”

A quick guide for junior doctors and general clinicians from patients living with Aspergillus-related conditions.

🦠 1. Aspergillus Isn’t Rare – It’s Just Underdiagnosed

• Aspergillus is everywhere — in air, soil, compost, buildings.

• For people with asthma, bronchiectasis, COPD, TB damage, or immune issues, it can cause serious illness.

• ABPA, CPA, SAFS, and invasive aspergillosis are all real, distinct, and increasingly recognised conditions.

🧩 If a patient has persistent cough, breathlessness, mucus, or lung cavities — consider fungal disease.

🔬 2. The Right Tests Make All the Difference

When symptoms don’t improve or don’t match classic asthma/COPD patterns, ask for:

• Aspergillus-specific IgE

• Total IgE

• Aspergillus IgG

• Sputum culture & fungal PCR

• HRCT chest (not just plain X-ray)

These tests are often missed unless someone thinks of them. Many patients go undiagnosed for years.

💊 3. Standard Inhalers Don’t Help Much – And Sometimes Make It Worse

• Patients may not respond well to bronchodilators or inhaled steroids alone.

• Fungal disease may need:

  • Oral corticosteroids (ABPA)

  • Antifungals (itraconazole, voriconazole, etc.)

  • Physiotherapy and airway clearance

  • Long-term follow-up

Think beyond asthma — especially when patients say their treatment isn’t working.

🧭 4. Aspergillosis Doesn’t Only Flare in Autumn

• Symptoms can worsen any time of year.

• Triggers include damp housing, indoor mold, infections, and environmental exposure.

• Delaying treatment because it’s “not autumn” can be dangerous.

🧠 5. Listen to Patients – They Often Know Their Condition Better Than Anyone

• Many of us have lived with this for years and have been misdiagnosed or dismissed before.

• We aren’t trying to self-diagnose — we’re trying to help you help us.

Respecting lived experience builds trust and improves care.

🏥 6. The National Aspergillosis Centre (NAC) in Manchester Exists

• If you’re unsure how to proceed, they are a world-leading centre of expertise.

• They support patients across the UK and provide diagnostic advice and treatment plans.

• Consider reviewing any clinic letters from NAC or contacting them for guidance.

• National Aspergillosis Centre – Wythenshawe Hospital

📄 Optional “One-liner” for Doctors to Note:

“Consider Aspergillus-related lung disease in patients with chronic respiratory symptoms and underlying airway disease, particularly when symptoms are recurrent, severe, or unresponsive to standard therapy.”