Aspergillus Fumigates

Aspergillus fumigates is one of the many fungus belonging in the family of Aspergillus species.  These species are ubiquitous saprobes and occurs worldwide. Aspergillus fumigates is one of the most common pathogen causing a disease. Colonies of this species produce small conidia that are easily aerosolized. Once inhaled, it causes severe allergic reactions especially in immunocompromised patients.

In normal healthy individuals, upon inhalation of the conidia, the alveolar macrophages are able to engulf the conidia thus destroying it. However, in immunocompromised individuals the macrophages have weakened ability to trap the inoculum. If this happens, conidia in the lung start to swell and germinate to produce hyphae that have the probability to invade preexisting cavities or blood vessels.

Aspergillus fumigates can bring about different clinical findings. Among which includes the following: Allergic bronchopulmonary aspergillosis,  Aspergilloma and Invasive aspergillosis.

In allergic bronchopulmonary aspergillosis, there is the presence of asthma, recurrent chest infiltrates, eosiniphilia and both type 1 and type 3 skin test hypersensitivity to Aspergillus antigen. Individuals experiencing allergic bronchopulmonary aspergillosis, often have difficulty in breathing and may develop lung scarring.

Aspergilloma occurs when inhaled conidium enters an existing cavity, germinates and produces abundant hyphae in the abnormal pulmonary space. Patients with previous history of sarcoidosis, tuberculosis and emphysema are at risk to such infection. This disease is characterized by cough, dyspnea, hemoptysis, and fatigue and weight loss.

Invasive aspergillosis follows after an inhalation and germination of conidia. Patients at risk in acquiring this disease are the immunocompromised.  Symptoms include cough, dyspnea,hemoptysis and fever.  From the lungs, the infection may spread to nearby organs such as the GI tract, kidneys and liver.

Allergic bronchopulmonary aspergillosis is treated with corticosteroids or disodium chromoglycate. Itraconazole or amphotericin B is usually used in treating fungal infections caused by Aspergillus fumigates and is best used in cases of Aspergilloma.  In treating Invasive aspergillosis, rapid administration of native or liquid formulation of amphotericin B or voriconazole is used.

Nursing Consideration

Since aspergillus fumigates only infect those individuals who are immunucompromised, it is best if these individuals are placed in a reverse isolation and their visitors should be kept to minimum. Their room should be always kept clean, free from molds and fungus or other materials where aspergillus fumigates will thrive. Fresh flowers and fresh fruits should not be given to these patients as gifts for these may harbor the fungi. As ordered by the doctor, patients at risk for acquiring invasive aspergillosis are given prophylactic low dose amphotericin B.

Daisy Jane Antipuesto RN MN

Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.

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