Aspergillus

Overview

Aspergillus is a common type of fungus or mold that you can find in soil, dust, and damp buildings. Most people breathe in Aspergillus spores (tiny particles) every day without any problems. In some people, especially those with certain health conditions, Aspergillus can cause an infection or allergic reaction. The group of illnesses caused by Aspergillus is called aspergillosis.

Aspergillus itself is very common. It exists all around us. Even the milder forms of aspergillosis are not common, but doctors see them in people with certain risk factors. The most serious form, invasive aspergillosis, is rare and mainly occurs in hospital patients with very weak immune systems.

Aspergillosis can affect individuals of any age, but it is most often seen in adults with asthma, cystic fibrosis, or other chronic lung problems. People who have had an organ transplant, are having some types of cancer treatment, or have a very weak immune system are also at higher risk. It rarely affects healthy people.

Symptoms

Common symptoms

• Cough that lasts a long time
• Wheezing or difficulty breathing
• Coughing up mucus or, in some cases, blood
• Fever that does not improve
• Chest pain
• Fatigue or feeling generally unwell

Symptoms in children

• Persistent cough
• Wheezing or noisy breathing
• Poor weight gain or delayed growth
• Tiredness and irritability

Symptoms in older adults

• Shortness of breath
• Confusion that is new or worse
• Weakness and fatigue
• Loss of appetite and weight loss

Causes

Main causes

• Breathing in tiny Aspergillus spores from the air
• Having a weakened immune system that cannot fight the fungus
• Having damage or disease in the lungs that lets the fungus grow

Risk factors

• Asthma or cystic fibrosis
• Use of steroid medicines for a long time
• Organ or stem cell transplant
• Low white blood cell count, often from cancer treatment
• Severe liver disease or diabetes that is difficult to control

When to see a doctor

See a doctor urgently if:

• Call your healthcare team or get same-day advice if you cough up blood or have a fever that lasts more than a few days.
• Seek urgent help if you have breathing difficulties that do not improve with your usual treatments.

Book a routine appointment if:

• Make an appointment if you have a cough that lasts more than three weeks.
• See a doctor if you have repeated wheeze or chest infections.
• If you have a lung condition and your symptoms change, mention it at your regular check-up.

Diagnosis

To diagnose aspergillosis, your doctor will ask about your symptoms and health history. They will listen to your chest and may arrange tests to look at your lungs and check for fungus.

Tests that may be done

• Chest X-ray or CT scan to look for changes in the lungs
• Sputum culture – a test on the mucus you cough up
• Blood tests to look for antibodies or signs of infection
• Bronchoscopy – a flexible tube with a camera to look inside the airways and take a small sample

What to expect at your appointment

You will likely be referred to specialists, such as a respiratory (lung) doctor or an infectious disease doctor. The tests are usually not painful, though a bronchoscopy might be uncomfortable. You may need more than one test to get a clear picture.

Treatment

Treatment depends on the type of aspergillosis you have and your general health. Some people need no treatment, while others need antifungal medicines or other therapy to control symptoms and prevent complications.

Self-care at home

• Take all prescribed medicines on schedule, even if you feel better.
• Try to avoid known damp or moldy environments that make your breathing worse.
• Use a mask if you must work in dusty or moldy places.
• Keep up with your regular check-ups for any underlying lung condition.

Medical treatments

Antifungal medicines are the main treatment for fungal infections caused by Aspergillus. For allergic forms of aspergillosis, your doctor may prescribe corticosteroid medicines (often inhaled) to reduce inflammation in the airways. In more serious infections, antifungal medicines may be given through a vein in the hospital. Doctors choose the specific treatment based on your condition and medical history. Always take medicines exactly as prescribed.

When is surgery considered?

Surgery is not often needed. It may be considered if a fungus ball (aspergilloma) in the lung causes repeated bleeding or pressure on the airways. Your surgical team will discuss possible benefits and risks before any procedure.

Living with this condition

Living with an Aspergillus condition means managing the underlying lung problem and reducing exposure to molds. You may need to take long-term medicines and have regular appointments with your specialist. Work with your care team to develop a plan that fits your life.

Lifestyle tips

• Keep your living space dry and well-ventilated.
• Fix leaks quickly and clean visible mold with proper safety measures.
• Avoid gardening or use a mask when in dusty, compost-rich areas.
• Stay active within your limits and rest when you need to.

Diet and exercise

Eating a balanced diet helps support your immune system. If you are on long-term steroids, your doctor may suggest watching your blood sugar. Gentle exercise, such as walking, can help keep your lungs strong, but check with your doctor before starting a new exercise routine, especially if you feel breathless.

Mental health and emotional wellbeing

Living with a chronic or serious lung condition can be stressful. You might feel anxious or low at times. It is normal to have these feelings. Talking to a counselor or a support group can help. If you are struggling, please discuss it with your healthcare team.

Prevention

It is not possible to avoid Aspergillus completely, because the spores are everywhere in the air. For most people, prevention is not necessary. For those at higher risk, simple measures can reduce the chances of breathing in large amounts of mold: stay indoors during building or gardening work, use proper masks, and make sure heating and cooling vents are clean.

Vaccines

There is no vaccine that prevents Aspergillus infection. The best prevention is to protect your immune system and limit exposure to damp, moldy environments if you are at high risk.

Screening programmes

There is no routine screening test for the general public. If you are at high risk – for example, after an organ transplant – your medical team will closely monitor you for early signs of infection and may order regular blood tests or scans.

Complications

If left untreated

• Mild allergic aspergillosis can damage the airways over time if not controlled.
• A fungus ball (aspergilloma) can grow and cause bleeding in the lungs.
• Invasive aspergillosis can spread to other parts of the body and become life-threatening if not treated quickly.

Long-term outlook

The outlook depends on the type of aspergillosis and your overall health. Many people live well with the condition, especially when they get the right care. Allergic forms can be managed well with medicines. Even serious infections can improve with timely treatment in hospital. Your doctors will work with you to give you the best possible outcome.

Find support

Local organisations

• NHS UK ↗ · United Kingdom

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