Aspergillosis

Presentation Developed By:

Katie Olenick, Jacquie Mohney
& Qazi Omair

http://agreenliving.org/tag/about-environment/

Names
People with Aspergillosis are in three distinct
groups
Healthy immune system

Non-invasive Aspergilloma
Chronic pulmonary Aspergillosis (CPA)
Allergic bronchopulmonary Aspergillosis (ABPA)
Fungal sinusitus (Fungal ball in the sinuses)
Otomycosis (Ear infection)
Keratitus (Eye infection)
Onychomycosis (Nail infection)

Names Cont
Damage or nonexistent immune system

Pulmonary Aspergilloma (Lungs)

Endocarditis, Mycarditis (Heart)
Cerebral Aspergillosis (Brain)
Renal Aspergillosis (Kidney)
Odteomyelitis (Bone)
Gastrointestinal tract

Chronic granulomatous disorder

Genetic
8 to 10 out of millions of people

Classification of Taxonomy

Kingdom (Fungi)
Phylum (Ascomycota)
Class (Ascomycetes)
Order (Eurotiales)
Family (Trichocomacaea)
Genus (Aspergillus)
Species: A. fumigatus, A. flavus, A. niger, A.
nidulans, A. terreus

Aspergillus fumigatus

Filamentous fungus
Worldwide
Airborne saprophytic fungi
Causes infection

A. flavus
Produces aflatoxin (most important known
microtoxins)
Imperfect ascomycete (does not produce
ascospores- makes asexual spores)
More common in air than A. fumigatus

A. niger
Multi-nucleate
Normally haploid
Found in agricultural products

A. nidulans

Ascomycetes
All are filamentous fungus
Asexual spores (Candida)
Sexual spores (Ascospores)
Develop 9 different cell types

A. terreus
Filamentous ascomycete
Produce lateral cells termed
aleuriospores

Life Cycle

Sarophytes
Production of conidia (asexual spores)
Primary route of human infection:
Inhalation
Conidial deposition

http://cmr.asm.org/content/vol22/issue3/images/large/zcm0030922850001.jpeg

Epidemiology

Most common in individuals with:

Asthma
Cystic fibrosis
Organ transplant patients
Immunosuppressed
Corticosteroid-induced patients
Neutropenia
The mortality rate in some groups is ~90%

Pathogenesis
Innate defenses
Risk of the disease
increases with the
Inflammatory
combination of:
Impacting proximal
mediators
events in conidial
Ex. Beta-Dclearance,
production
of
glucan
inflammation, and
killing of invasive forms
microbial factors
impacting disease
potential

http://www.longevity-and-antiaging-secrets.com/images/beta-d-glucan.jpg

Blood Test

Called aspergillus precipitin test

Detects antibodies to aspergillus

Imaging

Chest x-ray or CT scan

Lung cavity lesion or fungal ball (aspergilloma)

Skin Test

Aspergillus Ag injected into skin

Allergic reaction indicates circulating IgE
antibodies specific for aspergillus

Normal Chest X-Ray

http://www.broadwayradiology.co.nz/39.html

Pulmonary
Aspergillosis

http://www.humenhealth.com/aspergillosis/aspergillosis.asp

Sputum microscopic analysis

Filamentous fungus
Branching septate hyphae
with 45angle

Silver stains

Sputum culture

http://www.mycology.adelaide.edu.au/Mycoses/Opportunistic/Aspergillosis/

A. Fumigatus
(left)
A. Flatus
(right)
http://www.mycology.adelaide.edu.au/Fungal_Descriptions/Hyphomycetes_(hyaline)/Aspergillus/fumigatus.html

http://www.sickhousecenter.com/mold-pictures/

Symptoms

Fever
Cough
Hemoptysis Weight loss
Fatigue
Dyspnea

Similar to
lung cancer
tuberculosis
other lung infections

http://www.sciencephoto.com/media/250290/enlarge

Commonly found
opportunistic infection
AIDS
Cancer patients

Oral Corticosteroids

Standard treatment for allergic bronchopulmonary

aspergillosis to reduce inflammation
Will prevent existing asthma or cystic fibrosis from
worsening

Antifungal medication

Standard treatment for invasive pulmonary

aspergillosis
Historically has been Amphotericin B
Newer antifungals such as itraconazole and
voriconazole are now preferred

Aspergillomas
Surgical methods

Bleeding aspergilloma
Embolization

http://pathhsw5m54.ucsf.edu/case16/aspergilloma.html

http://www.njmoldinspection.com/mycoses/moldinfections.html

 Male
Weakness
Loss of bladder and
bowel control

Spinal epidural abcess

Aspergillus fumigatus
Cauda equina syndrome

Treatment
Surgical drainage
Voriconazole
Intraconazole

http://healthhackz.com/lower-back-pain-vital-details-about-low-back-soreness/

 Increased incidence
Preventative measures
Hedi Chaker Hospital
Hematology

Environmental Factors
Invasive Aspergillosis

http://www.inmagine.com/dki073/dki073003-photo

"Aspergillus/aspergillosis Website." The Aspergillus/Aspergillosis Website. Web. 10

July 2011.
<http://www.aspergillus.org.uk/secure/veterinary/chap1mammalian.htm>.

Batra, Sumit, Sumit Arora, Hemant Meshram, Geetika Khanna, Shabnam B. Grover,
and Vinod K. Sharma. "A Rare Etiology of Cauda Equina Syndrome." J Infect Dev
Ctries 5.1 (2011): 79-82. Print.
"CDC - Aspergillosis, General Information - NCZVED." Centers for Disease Control
and Prevention. 10 July 2010. Web. 8 July 2011.
<http://www.cdc.gov/nczved/divisions/dfbmd/diseases/aspergillosis/>.
Dagenais, T. R. T., and N. P. Keller. "Pathogenesis of Aspergillus Fumigatus in
Invasive Aspergillosis." Clinical Microbiology Reviews 22.3 (2009): 447-65. Print.
"Descriptions - Aspergillus Comparative." Broad Institute of MIT and Harvard. Web.
10 July 2011.
<http://www.broadinstitute.org/annotation/genome/aspergillus_group/GenomeD
escriptions.html>.

Resources Cont
"Diagnosis of Aspergillosis." The Aspergillus/Aspergillosis Website. Web. 8 July
2011. <http://www.aspergillus.org.uk/newpatients/diagnosis.php>.
Harman M.D., Eloise M. "Apergillosis." Medscape Reference. 7 June 2011. Web.
10 July 2011. <http://emedicine.medscape.com/article/296052-overview>.
"Human Aspergillosis - Home Inspection for Mold Relevant to Human Health."
Medical Mycologist Medical Toxicologist Certified Health Investigations for Mold
and Toxins for Health Investigations and Mold Testing with Full Indoor Air Quality
Analysis.NJ NY EMF Lead Radon Electromagnetic Radiation. Web. 10 July 2011.
<http://www.njmoldinspection.com/human_aspergillosis.html>.
Marr, Kieren A. "Epidemiology and Clinical Manifestations of Invasive
Aspergillosis." UpToDate Inc. Ed. Carol A. Kauffman and Anna R. Thorner. 2011.
Web. 8 July 2011. <http://www.uptodate.com/contents/epidemiology-andclinical-manifestations-of-invasive-aspergillosis>.

Resources Contd