Invasive aspergillosis (IA) is an infection caused by molds from the genus Aspergillus. These infections are rare but present in people whose immune systems are weakened by certain medical interventions such as chemotherapy for cancer, bone marrow transplantation, solid organ transplantation, or because someone is born with an underlying disease of their immune system. Invasive aspergillosis can be local to one organ or location (e.g., lungs or sinuses) but can disseminate to any other part of the body. If left untreated these infections are fatal.
What is invasive aspergillosis?
Aspergillosis is an infection caused by a mold called Aspergillus. Invasive aspergillosis is the most severe form of aspergillosis.
Who gets invasive aspergillosis?
Invasive aspergillosis occurs only in people whose immune systems are weakened. The immune system may be weakened after exposure to chemotherapy for cancer, bone marrow transplantation, solid organ transplantation, or because someone is born with an underlying disease of their immune system.
Known risk factors for IA include:
- Hematological and oncological malignancies
- Prolonged neutropenia
- Use of immunosuppressant drugs, such as corticosteroids
- Acquired immune deficiency syndrome
- Primary immune deficiency such as chronic granulomatous disease
- Organ transplant recipients
- Bone marrow transplant recipients
- Preceding severe respiratory viral infection, such as influenza or COVID-19
What causes invasive aspergillosis?
Aspergillus can cause serious illnesses when an immune suppressed person inhales fungal spores. These strains are most dangerous for people with weakened immune systems. After inhalation of the spores, Aspergillus can colonize the lungs, resulting in invasion of lung tissue; the infection can then disseminate to other organs, including the central nervous system. Infection can also start in the skin if Aspergillus spores are pressed to the skin surface, such as with a band-aid, or gain access through an area of local trauma, in someone with an immune suppressed state.
How is invasive aspergillosis diagnosed?
Diagnosing invasive aspergillosis can be difficult. Aspergillus is common in all environments. Your healthcare professional may use the following tests to determine if you have invasive aspergillosis: an imaging test such as a CT scan, a respiratory secretion test, blood tests, and in some cases a biopsy from the area where there is a concern for infection.
What is the treatment for invasive aspergillosis?
Antifungal medicines are the standard treatment for invasive pulmonary aspergillosis. Voriconazole, posaconazole, or iszavunconazole are the preferred agents for first-line treatment. Liposomal Amphotericin B is another option. Sometimes surgical resection of an involved area is considered to hasten the resolution of infection.