– a disease caused by fungi of the genus Aspergillus with frequent localization in the bronchopulmonary system.

Etiology and pathogenesis of Aspergillosis

Aspergillus-widely distributed in nature saprophytes that secrete spores year-round. The disease is caused by inhaling a large number of Aspergillus spores, for example, when working with moldy rotting hay, compost. In pathogenesis, in addition to the allergizing and hemolytic effects of endotoxin, a large role is played by reducing the reactivity of the body in chronic diseases (tuberculosis, suppuration, neoplasms, systemic blood diseases, alcoholism, HIV infection, etc.) or with prolonged use of glucocorticoids, cytostatics.

Symptoms and courseAspergillosis

Allergic bronchopulmonary aspergillosis occurs in healthy individuals with an initially unchanged immunological status. Characterized by fever, bronchospasm; sputum may have a brown tinge, sometimes cough up casts of the bronchi; examination reveals transient pulmonary infiltrates, proximal bronchiectases, peripheral blood eosinophilia, increased levels of class e immunoglobulins.

The course can be prolonged with repeated exacerbations and the development of severe bronchial asthma; in some cases, recovery occurs.

Types Of Aspergillosis

Endobronchial pulmonary aspergillosis is characterized by a productive cough, often-hemoptysis. An aspergilloma (a colony of mycelium of the fungus, lying freely in a tuberculous cavity, in the cavity of the abscess, bronchiectasis, the plot slowly absorbable pneumonia, pulmonary infarction, in tumors) may be asymptomatic, but often there are a cough with sputum without odor, hemoptysis, loss of body weight (up to cachexia), fever, chest pain, progressive deterioration.

Aspergillosis pneumonia (single or multiple foci in the middle and lower parts of both lungs) with frequent formation of cavities is observed more often in patients with immunodeficiency. In diagnostics, data from x-ray studies, sputum cultures, and serological methods are used.


Etiotropic therapy of aspergillosis involves the use of fungicides. Effective amphotericin B. the Daily dose (250 U/kg) is administered in 450 ml of 5% solution of sterile glucose in / in a drip for 46 hours every other day or 2 times a week for 48 weeks; inhalation of 50,000 U of amphotericin In 10 ml of water for injection is made 12 times a day for 10-14 days. Amphotericin B has the ability to accumulate, neuro, nephro and hepatotoxic. In the absence of severe immunodeficiency, Itraconazole (Orungal) is also used 200 mg 2 times a day.

In allergic bronchopulmonary aspergillosis, glucocorticoids are used. The dose of prednisone in the acute stage or with an exacerbation of the disease is 0.5 mg/kg daily until the disappearance of pulmonary infiltrates. Then for 3 months. the patient takes 0.5 mg / kg of prednisone every other day, during the next 3 months. the dose of the drug is gradually reduced until it is completely canceled. The use of fungicides (amphotericin B, Itraconazole) is possible only in the remission stage, since the massive death of the fungus can weigh down the condition of patients.

Surgical treatment is carried out with the abscessed Aspergillus pneumonia, aspergilloma with severe hemoptysis.