01 February is World Aspergillosis Day. The aim is to raise awareness of a fungal infection that is little known to most people but can cause severe disease and death to vulnerable patients.
What is aspergillus?
Aspergillus is a mould which exists in the air and enters the body through inhalation as we breathe. In most people, the lungs are able to clear it without allowing it to cause disease. However, in patients with weakened immune systems, like those who have undergone chemotherapy or steroid therapy, the mould is able to remain and cause infection (aspergillosis). These patients may present with fever, a cough, and even bring up blood in their phlegm (haemoptysis).
Patients with chronic lung conditions can also be affected. In fact, aspergillosis is thought to affect around 5-10% of patients who have been previously treated for tuberculosis (TB). Given that TB is such a common disease in the world, it follows that aspergillosis affects large numbers of patients around the world as well.
Aspergillus can also exacerbate asthma; it is thought that this happens to around 3% of people with asthma. In these patients, exposure to mouldy or damp environments can make their symptoms worse and reduce their lung function.
Problems with diagnosing aspergillosis
Aspergillus is often difficult to diagnose as it may not grow readily in routine cultures in the laboratory, therefore is its important that the doctor suspects aspergillosis and requests the appropriate tests. Unfortunately, aspergillosis often remains unrecognised due to doctors not suspecting the infection and/or not requesting the correct test. Delayed or absent diagnosis of aspergillosis carries serious consequences, including death.
Thankfully, there are effective treatments for aspergillosis in the form of anti-fungal agents. However, the number of different anti-fungals available is limited and drug-resistance may occur in some patients, thus inhibiting the efficacy of treatment. Consequently, research and development of new agents is needed.