Aspergillosis
Aspergillosis is a group of conditions caused by Aspergillus mould, ranging from allergy and a fungal ball in an existing lung cavity to invasive infection.
Key points
- The clinical form matters: allergic disease, chronic pulmonary aspergillosis and invasive infection are treated differently.
- A positive culture or antibody result must be interpreted with symptoms and imaging because airway colonisation can occur without disease.
- Immune suppression, transplantation, prolonged neutropenia and certain lung conditions increase the risk of invasive illness.
The listings below do not identify the form of aspergillosis; antifungal treatment requires specialist diagnosis and interaction review.
How diagnosis is established
Chest CT, fungal culture, antigen or antibody testing and sometimes bronchoscopy or tissue sampling are combined according to the presentation. Asthma with recurrent mucus plugging suggests allergic disease, while fever and lung changes during profound immune suppression raise concern for invasion.
Antifungal decisions
Not every form needs the same antifungal, and an asymptomatic fungal ball may sometimes be observed. Azole medicines have important liver, heart-rhythm and drug-interaction risks and may need level monitoring. Invasive disease requires urgent systemic therapy and management of immune risk where possible.
When to seek urgent care
Seek urgent care for coughing blood, severe or worsening breathlessness, chest pain, confusion, blue lips, or fever during significant immune suppression.