Aspergillosis
Aspergillosis or aspergillosis is a disease caused by infection with the fungus Aspergillus. Almost every time humans inhale Aspergillus spores without getting sick. However, people with weak immune systems are at risk of experiencing health problems due to this mold. Aspergillus fungi, especially affecting lung tissue, cause the four most common syndromes, namely:
- Aspergillosis Bronchopulmonary Allergy (Allergic Bronchopulmonary Aspergillosis /ABPA).
- Aspergiloma (Aspergilloma).
- Pneumonia Aspergillosis Kronik (Chronic Necrotizing Aspergillosis Pneumonia/CNPA).
- Invasive Aspergillosis .
In people with very weak immune systems ( immunocompromised ), Aspergillus infection can spread from the lungs to the eyes (causing endophthalmitis ), heart (causing endocarditis ), abscesses in the heart muscle, kidneys, liver, spleen, soft tissues, central nervous system, and bones. Although it is a type of lung infection, aspergillosis cannot be transmitted between humans or from humans to animals and vice versa.
Symptoms of Aspergillosis
The symptoms experienced by aspergillosis sufferers depend on the type of aspergillosis they have, namely:
- In ABPA, it usually occurs in people with asthma and cystic fibrosis. In ABPA, aspergillus causes inflammation due to an allergic reaction and causes allergy symptoms, such as coughing and wheezing. In addition, there may also be complaints of fever and on examination, signs of lung inflammation are found that do not improve with antibiotic therapy.
- Aspergilloma is a ball of fungus that is in a pre-existing cavity. Usually, it occurs in TB or other lung infections that have been treated. One of the common complaints is severe coughing up of blood. In addition, sufferers usually also experience fever.
- CNPA is a slow-growing aspergillosis infection, usually occurring in people with long-standing lung disease, such as chronic obstructive pulmonary disease (COPD), alcohol users, or those taking steroid medications for a long time. Symptoms usually include fever, cough, night sweats, and weight loss. These symptoms are similar to those of TB or pneumonia, but the TB test results are negative and do not improve with antibiotics.
- Invasive aspergillosis is a rapidly developing aspergillosis infection that is often fatal in people with low immune systems, such as organ transplant patients, HIV/AIDS patients, or chronic granulomatous diseases. This infection is usually accompanied by the spread of infection to other organs, especially the central nervous system. Complaints experienced include fever, cough, shortness of breath, chest pain, coughing up blood, rapid breathing, and low blood oxygen levels that are getting worse.
Causes of Aspergillosis
The cause of aspergillosis fungal infection is inhalation of aspergillus spores in people with risk factors, namely low immunity. Aspergillus fungi are molds or filamentous fungi that are common everywhere from highlands to lowlands and are usually found in fertile areas, including in Indonesia. This fungus is also found in compost, bird droppings, tobacco, and potatoes that have been stored for a long time.
Risk Factors for Aspergillosis
Risk factors for aspergillosis include:
- Having asthma or cystic fibrosis puts you at risk for developing ABPA.
- Having a lung disease, such as Tuberculosis (TB), puts you at risk of developing Aspergilloma.
- People with lung diseases, such as TB, COPD, or sarcoidosis are at risk of developing CNPA.
- People who have undergone organ transplantation or have a very low immune system, for example undergoing cancer therapy, or who take long-term or high-dose steroids are at risk of developing invasive aspergillosis.
Diagnosis Aspergillosis
The diagnosis of aspergillosis is based on the findings of signs and symptoms in interviews and physical examinations. Suspicion of fungal infection is usually directed at sufferers with complaints consistent with aspergillosis, namely:
- ABPA
The diagnosis of ABPA is based on the presence of abnormalities, such as:
- Having asthma or cystic fibrosis
- There is coughing, wheezing, increased phlegm, and difficulty in carrying out activities.
- There are eosinophil results in the blood test
- Other allergy test results showed positive results.
- Chest X-ray or CT scan shows lung inflammation.
- Microscopic examination, culture, and antigen/antibody positive for aspergillosis
- Aspergilloma
Aspergilloma can be seen mainly through imaging tests, such as chest X-rays. In this examination, a cavity containing a solid mass will be found that changes position when the sufferer changes position. This examination can be confirmed with a CT scan that can more clearly see the fungus ball and multiple aspergilloma.
- Invasive Aspergillosis and CNPA
The diagnosis of invasive aspergillosis and CNPA depends on which tissue is affected. The doctor will perform a physical examination according to the complaint, X-ray / CT Scan, microscopic examination, and culture and detection of antigens/antibodies from sputum or biopsy samples.
Aspergillosis Treatment
Aspergillosis therapy depends on the type experienced, namely:
- ABPA
In aspergillosis caused by allergic reactions such as ABPA, antifungal drugs, and steroids can be given to relieve symptoms.
- Aspergilloma
In aspergilloma, surgical therapy is the main therapy to remove the fungal ball from the lungs as well as administering antifungals.
- CNPA
In CNPA, antifungals are given and seen whether there is a response or not. Surgery may be recommended if there is extensive damage or does not respond to medication.
- Invasive Aspergillosis
In invasive aspergillosis, antifungal therapy is given, immunosuppressive therapy is discontinued, or surgery is required if necessary.
Prevention of Aspergillosis
It is very difficult to prevent yourself from inhaling Aspergillus spores because this fungus is almost everywhere. If the sufferer has a weak immune system, then you can do the following:
- Using a mask;
- Prevent direct contact with dust or soil, for example by using personal protective equipment, such as long clothes, boots, and gloves;
- Treat immediately if there are wounds on the body; and
- If you have been exposed, immediately consult your nearest doctor.
When to See a Doctor?
Contact a doctor immediately if you experience the above symptoms. Proper handling can minimize the consequences so that treatment can be done more quickly.