Long Term Semi Invasive Pulmonary Aspergillosis

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Aspergillus is a common indoor and outdoor fungi (mold) which can produce many toxins or mycotoxins (such as aflatoxins, ochratoxins, and sterimatocystin). It can also cause life threatening invasive bloodstream infections which commonly affect immunocompromised people such as those with HIV, some forms of cancer like leukemia and lymphoma, the severely malnourished, and patients on immunosuppressive drugs for bone or organ transplants.     

Jasper Chan et al. A 10-year study reveals clinical and laboratory evidence for the “semi-invasive” properties of chronic pulmonary aspergillosis. Emerging Microbes and Infections 2016, 5, e37, doi:10.1038/emi.2016.31

Even with hospital treatment and strong anti-fungal drugs are still fatal about 40 to 90% of the time. Aspergillus can also exist as a low level lung infection in patients with allergic bronchopulmonary aspergillosis (ABPA). Aspergillus infections can also cause more serious lung infections than ABPA but still not cause invasive bloodstream infections. Such infections are called “chronic pulmonary aspergillosis (CPA)” and have intermediate characteristics between invasive aspergillosis and ABPA.

Chronic pulmonary aspergillosis can cause cavitary lesions in the lungs and have culturable Aspergillus in the lungs and/or pleural cavity. The most common most common Aspergillus causing lung infections in CPA are Aspergillus fumigatus and flavus. CPA infections can often be fatal, one study of 29 CPA patients reported a 28% mortality rate over a 2 year period.
 

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