aspergillos

Hi all,

Has anyone had this and if so how long did you have treatment for and did it improve your asthma.

My daughter has had the blood test for this today and i was just wondering!

Thanks in advance for any advice

mellers

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Hello,

I had the blood test for this done too, chest clinic told me that for me it means that i have to avoid this spore which is found in damp places like compost heaps, piles of damp leaves etc. I was also advised to steer clear of damp, mouldy enviroments which as an asthmatic to be honest i did already.

I think aspergilliosis is a condition too as well as being sensitive to a particular mould spore but i can't remember, sorry. They gave me a leaflet that i'll try and dig out, EmH or CathBear will know much more than me though, sorry can't help more, love Lois

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Hi there I have aspergillos diagnosed by a blood test. Apparantly it means my chest is colonised with it, which can make asthma worse. I am taking an anti-fungal called itraconazole which i need to take for a year. I know it can cause a nasty pneumonia too which is treated in the same way.

Hope this helps.

Sadwheezer

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Lois & Mellers,

Aspergillus fumigatus (I think this might be the name that you were searching for) is the most common type of spores found in the environment and has the ability to affects many asthmatics. A. fumigatus also has the ability cause allergic type symptoms without colonising in the respiratory system.

A. fumigatus can be found both outdoors and indoors. The black musty patches often found on walls and ceiling of damp rooms is A. fumigatus.

Asthmatics should stay well clear of refurbishment works being carried out in old houses/buildings as this is known to cause hugely elevated levels of A. fumigatus spores to become airborne.

There is a website dedicated to Aspergillosis somewhere, trying googling it if you require detailed information or want to contact their help group.

I hope this helps a little.

Take hair,

Derek

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Hi all,

Try aspergillus.org.uk/ - a very good and informative website for patients and healthcare professionals.

It's quite a complicated topic and I don't claim to understand it completely. The group of moulds Aspergillus can cause mischief to asthmatics and non-asthmatics in several different ways.

You can have a straightforward allergy to Aspergillus moulds - like any other allergy, this means that if you come into contact with it (in damp musty places, etc) you will get symptoms such as wheeze, cough, rhinitis etc. This is fairly common in asthmatics. The blood test for this would be RAST IgE specific to Aspergillus (skin prick tests are also used), which will only demonstrate that you have an allergy.

Allergic Bronchopulmonary Aspergillosis (ABPA) is less common - in this condition, which mostly affects asthmatics and others with chronic lung disease, the aspergillus mould actually colonises the lungs. This causes problems in several ways - by the body mounting an allergic response to the mould, by the mould itself attacking the lung tissue, and by plugs of sputum and mould blocking the bronchioles. It can just cause worsening of asthma and difficulty in control, or it can present with recurrent episodes of pneumonia-like illness, with cough, wheeze, general malaise and coughing up thick plugs of brown coloured sputum. Eventually if not treated it can cause bronchiectasis - scarring and thickening of the bronchi which then further encourages infection - and also pulmonary fibrosis. It's diagnosed by both a positive RAST test or skin prick test and seeing the threads of the fungus in the sputum, as well as characteristic changes in the blood tests. Thankfully it responds pretty well to steroids to damp down the allergic reaction and antifungals such as itraconazole to actually kill the fungus.

Aspergilloma is a slightly different version of Aspergillus infection in the lung, where a cavity from a previous lung disease such as TB or sarcoid becomes infected with the Aspergillus fungus. It's pretty rare and is really only found in people who do have these pre-existing lung cavities, which is much less common these days with improved treatment of TB. The cavities can be seen on X ray and have a characteristic appearance which I could probably draw for you, as they feature heavily in exams, if rarely in real life! They also produce highly positive RAST tests. Aspergillomas often don't cause too many problems, but they don't really respond to antifungal treatment because the fungus is safely walled off in the cavity. They can sometimes be removed surgically if they are causing problems. There is a risk of invasive aspergillosis if someone with an aspergilloma is immunosuppressed for any reason, so they are often screened for and removed in at risk individuals before giving steroids, chemotherapy etc.

Invasive aspergillosis is a very rare and nasty manifestation of disease caused by Aspergillus. Basically it's a sort of fungal septicaemia, with the fungus spreading all over the body. It's really only seen in very immunosuppressed individuals - such as folks with untreated HIV infection. It doesn't usually affect those who are just a little immunosuppressed from being on steroids, methotrexate and so on. These days it's rarely seen, as HIV treatment has much improved. It's treated with aggressive IV antifungal agents such as amphotericin, but it is a very nasty and difficult to treat condition.

I hope that makes sense - it's a while since I had to learn all this for ye olde exams but I think the synapses are firing somewhere deep inside my brain!

Basically the take home message is that if you have difficult asthma, especially if you get recurrent episodes of chest infections and malaise, it's worth asking for a RAST or skin prick test and microscopy of your sputum to see if you are allergic to Aspergillus and to rule out ABPA.

Hope this helps rather than confuses!

Em H

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aspergillos

Hi all,

WOW thanks very much for all your replies, all we have to do is wait now for the blood test results.

Thanks again

Mellers

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Bringing to the top, as a couple of people have PMed me asking about ABPA

Em