Health Encyclopedia

Pulmonary aspergillosis - invasive

Definition

Invasive pulmonary aspergillosis is an infection of the lungs caused by a fungus.

Alternative Names

Aspergillosis - acute invasive

Causes, incidence, and risk factors

Aspergillosis is caused by the fungus aspergillus, which is commonly found in nature but only rarely causes illness in people.

Invasive pulmonary aspergillosis is the most serious type of aspergillosis infection. It can affect any organ, particularly the heart, lungs, brain, and kidneys.

People with a weakened immune system (for example, from chemotherapy or HIV) are most likely to develop this kind of infection.

The most common type of immune system problem that causes this infection is a very low white blood cell count over a long period. People who have had chemotherapy or a bone marrow transplant sometimes have this type of problem.

Symptoms

Chest pain
Cough
Fever
Joint pain
Shortness of breath
Unintentional weight loss

Signs and tests

Listening to the chest with a stethoscope (auscultation) may reveal crackles or a sound made by the inflamed lining of the lung rubbing against the lung (pleural friction rub).

Tests may include:

Bronchoscopy with bronchoalveolar lavage and transbronchial biopsy
CBC
Chest CT scan
Chest x-ray
Open lung biopsy
Sputum culture and fungal stains

Treatment

The goal of therapy is to treat any immune problems and to control the infection with antifungal medications. In the past, antifungal therapy involved a potentially harmful antibiotic called amphotericin B. Several less toxic drugs have been introduced that work against aspergillus.

If white blood cell counts are too low, the patient usually must reduce or stop immunosuppressive drug therapy and begin treatment with granulocyte-colony-stimulating factor (GCSF). This treatment stimulates the body's production of infection-fighting white blood cells.

Expectations (prognosis)

Patients with the invasive form of pulmonary aspergillosis are usually critically ill. The disease is difficult to cure. Talk to your health care provider about your individual case.

Complications

This infection can damage multiple organs, eventually causing multi-organ system failure.

Calling your health care provider

Call your health care provider if you develop symptoms of this disorder. If you know you have a low white blood cell count and have fevers or symptoms of a respiratory infection, you should immediately tell your health care provider. An early diagnosis may improve the chance of a good outcome.

Prevention

If your immune system isn't working properly because of disease or medications, tell your doctor right away if you see new symptoms.

References

Goldman, L. Cecil's Textbook of Medicine. 23rd ed. Philadelphia, Pa: Saunders; 2007.

Review Date:11/12/2007
Reviewed By:Andrew Schriber, M.D., F.C.C.P., Specialist in Pulmonary, Critical Care, and Sleep Medicine, Virtua Memorial Hospital, Mount Holly, New Jersey. Review provided by VeriMed Healthcare Network.

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