Aspergilloma
Encyclopedia
An aspergilloma, also known as a mycetoma or fungus ball, is a clump of fungus
which exists in a body cavity such as the lung
. It is associated with the Aspergillus
species
, but Zygomycota
and Fusarium
may also form similar structures.
, the most common species, is typically inhaled as small (2 to 3 micrometer
) spore
s which do not affect people without underlying lung or immune system
disease
. However, people who have pre-existing lung problems, especially the cavities typically caused by tuberculosis
, are at risk for developing aspergillomae. The fungus settles in a cavity and is able to grow free from interference because the immune system is unable to penetrate into the cavity. As the fungus multiplies, it forms a ball, which incorporates dead tissue from the surrounding lung, mucus, and other debris.
s related to the infection. People often co-exist for decades with aspergillomae prior to incidental diagnosis
, typically by X-ray
or computed tomography
. However, a small percentage of aspergillomae invade into the wall of the cavity and can result in bleeding. Thus, the most common symptom of associated with aspergillomae is cough
ing up blood (hemoptysis
). Although this can occasionally be life-threatening, the amount of blood produced is usually inconsequential.
Aspergillomae can form in other body cavities. They can form abscess
es in the brain, usually in people who are immunocompromised. They can also form within the different sinuses
in the face, within the kidney
s and urinary system
, the ear canal
, and on the heart valve
s.
may be required to remove the aspergilloma and stop the bleeding. There has been interest in treatment with antifungal medication
s, such as itraconazole
, but as of 2005, none has been shown to eradicate aspergillomae.
Fungus
A fungus is a member of a large group of eukaryotic organisms that includes microorganisms such as yeasts and molds , as well as the more familiar mushrooms. These organisms are classified as a kingdom, Fungi, which is separate from plants, animals, and bacteria...
which exists in a body cavity such as the lung
Lung
The lung is the essential respiration organ in many air-breathing animals, including most tetrapods, a few fish and a few snails. In mammals and the more complex life forms, the two lungs are located near the backbone on either side of the heart...
. It is associated with the Aspergillus
Aspergillus
Aspergillus is a genus consisting of several hundred mold species found in various climates worldwide. Aspergillus was first catalogued in 1729 by the Italian priest and biologist Pier Antonio Micheli...
species
Species
In biology, a species is one of the basic units of biological classification and a taxonomic rank. A species is often defined as a group of organisms capable of interbreeding and producing fertile offspring. While in many cases this definition is adequate, more precise or differing measures are...
, but Zygomycota
Zygomycota
Zygomycota, or zygote fungi, is a phylum of fungi. The name comes from zygosporangia, where resistant spherical spores are formed during sexual reproduction. Approximately 1060 species are known. They are mostly terrestrial in habitat, living in soil or on decaying plant or animal material...
and Fusarium
Fusarium
Fusarium is a large genus of filamentous fungi widely distributed in soil and in association with plants. Most species are harmless saprobes, and are relatively abundant members of the soil microbial community. Some species produce mycotoxins in cereal crops that can affect human and animal health...
may also form similar structures.
Etiology
The most common place affected by aspergillomas is the lung. Aspergillus fumigatusAspergillus fumigatus
Aspergillus fumigatus is a fungus of the genus Aspergillus, and is one of the most common Aspergillus species to cause disease in individuals with an immunodeficiency....
, the most common species, is typically inhaled as small (2 to 3 micrometer
Micrometre
A micrometer , is by definition 1×10-6 of a meter .In plain English, it means one-millionth of a meter . Its unit symbol in the International System of Units is μm...
) spore
Spore
In biology, a spore is a reproductive structure that is adapted for dispersal and surviving for extended periods of time in unfavorable conditions. Spores form part of the life cycles of many bacteria, plants, algae, fungi and some protozoa. According to scientist Dr...
s which do not affect people without underlying lung or immune system
Immunodeficiency
Immunodeficiency is a state in which the immune system's ability to fight infectious disease is compromised or entirely absent. Immunodeficiency may also decrease cancer immunosurveillance. Most cases of immunodeficiency are acquired but some people are born with defects in their immune system,...
disease
Disease
A disease is an abnormal condition affecting the body of an organism. It is often construed to be a medical condition associated with specific symptoms and signs. It may be caused by external factors, such as infectious disease, or it may be caused by internal dysfunctions, such as autoimmune...
. However, people who have pre-existing lung problems, especially the cavities typically caused by tuberculosis
Tuberculosis
Tuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body...
, are at risk for developing aspergillomae. The fungus settles in a cavity and is able to grow free from interference because the immune system is unable to penetrate into the cavity. As the fungus multiplies, it forms a ball, which incorporates dead tissue from the surrounding lung, mucus, and other debris.
Clinical syndrome
Typically, individuals who are affected by aspergillomae do not have symptomSymptom
A symptom is a departure from normal function or feeling which is noticed by a patient, indicating the presence of disease or abnormality...
s related to the infection. People often co-exist for decades with aspergillomae prior to incidental diagnosis
Diagnosis
Diagnosis is the identification of the nature and cause of anything. Diagnosis is used in many different disciplines with variations in the use of logics, analytics, and experience to determine the cause and effect relationships...
, typically by X-ray
X-ray
X-radiation is a form of electromagnetic radiation. X-rays have a wavelength in the range of 0.01 to 10 nanometers, corresponding to frequencies in the range 30 petahertz to 30 exahertz and energies in the range 120 eV to 120 keV. They are shorter in wavelength than UV rays and longer than gamma...
or computed tomography
Computed tomography
X-ray computed tomography or Computer tomography , is a medical imaging method employing tomography created by computer processing...
. However, a small percentage of aspergillomae invade into the wall of the cavity and can result in bleeding. Thus, the most common symptom of associated with aspergillomae is cough
Cough
A cough is a sudden and often repetitively occurring reflex which helps to clear the large breathing passages from secretions, irritants, foreign particles and microbes...
ing up blood (hemoptysis
Hemoptysis
Hemoptysis or haemoptysis is the expectoration of blood or of blood-stained sputum from the bronchi, larynx, trachea, or lungs Hemoptysis or haemoptysis is the expectoration (coughing up) of blood or of blood-stained sputum from the bronchi, larynx, trachea, or lungs Hemoptysis or haemoptysis ...
). Although this can occasionally be life-threatening, the amount of blood produced is usually inconsequential.
Aspergillomae can form in other body cavities. They can form abscess
Abscess
An abscess is a collection of pus that has accumulated in a cavity formed by the tissue in which the pus resides due to an infectious process or other foreign materials...
es in the brain, usually in people who are immunocompromised. They can also form within the different sinuses
Paranasal sinus
Paranasal sinuses are a group of four paired air-filled spaces that surround the nasal cavity , above and between the eyes , and behind the ethmoids...
in the face, within the kidney
Kidney
The kidneys, organs with several functions, serve essential regulatory roles in most animals, including vertebrates and some invertebrates. They are essential in the urinary system and also serve homeostatic functions such as the regulation of electrolytes, maintenance of acid–base balance, and...
s and urinary system
Urinary system
The urinary system is the organ system that produces, stores, and eliminates urine. In humans it includes two kidneys, two ureters, the bladder and the urethra.-Kidney:...
, the ear canal
Ear canal
The ear canal , is a tube running from the outer ear to the middle ear. The human ear canal extends from the pinna to the eardrum and is about 35 mm in length and 5 to 10 mm in diameter....
, and on the heart valve
Heart valve
A heart valve normally allows blood flow in only one direction through the heart. The four valves commonly represented in a mammalian heart determine the pathway of blood flow through the heart...
s.
Treatment
Most cases of aspergilloma do not require treatment. Treatment of diseases which increase the risk of aspergilloma, such as tuberculosis, may help prevent their formation. In cases complicated by severe hemoptysis, surgerySurgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...
may be required to remove the aspergilloma and stop the bleeding. There has been interest in treatment with antifungal medication
Medication
A pharmaceutical drug, also referred to as medicine, medication or medicament, can be loosely defined as any chemical substance intended for use in the medical diagnosis, cure, treatment, or prevention of disease.- Classification :...
s, such as itraconazole
Itraconazole
Itraconazole , invented in 1984, is a triazole antifungal agent that is prescribed to patients with fungal infections. The drug may be given orally or intravenously.-Medical uses:...
, but as of 2005, none has been shown to eradicate aspergillomae.
External links
- Full details of the treatment of aspergilloma and other chronic invasive aspergillosis cases can be found at the Aspergillus Website Treatment Section along with all other types of aspergillosis and antifungal drugs both established and in development.
- People with chronic aspergillosis can find support on the Aspergillosis Website Patients Section.
- Aspergillus - Aspergillus Website (diagnosis, treatment, cases, images, educational video)
- Aspergillus Patients Support - Aspergillus Patients (questions and answers, support group)