CLINICAL FEATURES
Once inside the body, aspergillus can cause one of many infections -

Allergic aspergillosis
An allergic reaction to antigens on the spores.
Causes asthmatic symptoms.
cough
Common in those who work with infected hay

Bronchopulmonary aspergillosis
Allergic response - type I and III hypersensitivity.
Rarely causes tissue invasion but organism can be cultured from sputum.
Coughing, wheezing and
shortness of breath are symptoms
Common in asthmatics and those with cystic fibrosis

Colonizing aspergillosis
Fungi colonize respiratory tract
Development of fungal balls in the lungs - aspergillomas
Aspergillus forms dense mycelial masses which are localised in the lungs.
Non invasive - doesn't spread.

Invasive Disseminated aspergillosis
Fungi colonize in respiratory tract
Fungus spreads to almost any organ and tissue in the body
Only in severe immunocompromised hosts
Whole lung may fill with mycelia
Fungus balls may block off sections of the lung
Can disseminate from lungs or from wound - problem in transplants where immune system is artificially suppressed....
Mainly caused by Aspergillus flavus
Fever, cough, chest pains.
TB and bronchitis sufferers pose greater risks.

Cutaneous Disease
In rare cases - nosocomial and cutaneous wound infections
, following surgery, catheter sites and burn wounds

DIAGNOSIS
Difficule - usually requires biopsy.
Examination of pathological specimens
Advent of effective less toxic oral antifungal drugs (itraconazole) makes improved therapy possible.
Chest X-rays and information from the biopsy or smear may also be helpful.
By examining a biopsy (a small tissue sample) or a smear of sputum or mucus

TREATMENT AND PREVENTION
Treat the underlying cause of the infection to increase host resistance
Then treat the fungi with itraconazole.
Patient outcome depends on regaining immune status and early institution of effective antifungal drug therapy.
Severe infections treated with amphotericin B.
Fungal balls often require surgery to remove the fungus.