Lung infections are common disease phenomena, familiar sources of infection, usually viruses or bacteria, and relatively unfamiliar with fungi. In fact, lung diseases caused by fungal infections are not uncommon, and the number of cases of Aspergillus infections is increasing year by year. Relevant studies have shown that among our compatriots, there are about 40,000 patients with chronic pulmonary aspergillosis, in addition, there are 490,000 cases of allergic bronchopulmonary aspergillosis, and 16 cases of invasive pulmonary aspergillosis. What are the characteristics of Aspergillus infection? How should we identify and respond? Let's solve your doubts now.
Aspergillus, a filamentous fungus, belongs to the condition pathogenic bacteria, also known as opportunistic pathogenic bacteria. That is to say, between the body and the microbiota, or between the microbiota, there is a mutual restriction relationship between nutrient competition and metabolites, if this balance is broken, the flora that did not cause disease before will become pathogenic bacteria. Usually, pathogenic phenomena occur in three cases, the first of which is that certain flora leaves the normal hermitage site and is free from the original constraints. The second is that the body's immunity decreases, causing the blood of the microflora to spread. The third type is dysbacteriosis.
Aspergillus, mainly found in soil, air, water, dead plants, animal excrement, moldy food or clothing, is a place where Aspergillus is easy to survive. This bacterium, capable of growing in environments ranging from 6 to 55 degrees Celsius and at low humidity, produces large numbers of spores and spreads through the air. Spores can be suspended in the air and enter the human body through the respiratory tract. After the spores enter the body, they can parasitize, colonize, and then spread to multiple organs throughout the body, such as the eyes, skin, gastrointestinal tract, nervous system, etc. When the body's immune function declines, it can cause aggressive diseases. Therefore, patients with immunosuppression due to disease or taking drugs, or malignant tumors, are prone to aspergillosis infections due to agranulocytosis. In addition, in cases such as respiratory viral infections, the epithelial cells of the lungs are damaged, which provides an opportunity for aspergillus colonization.
Aspergillus infection is an opportunistic pathogenic infection, so after infection, it lacks specific manifestations and is not easy to detect. Aspergillus infection can lead to different types of diseases, of which invasive pulmonary aspergillosis is the most serious, and patients will have dry cough, hemoptysis, chest pain, fever, and difficulty breathing. Bronchopulmonary aspergillosis, mainly in children and adolescents, cough, wheezing, chest pain is a common symptom, patients may cough up bronchial dendritic sputum plugs, at the same time, may be accompanied by pollen allergy, allergic dermatitis, rhinitis, conjunctivitis and other allergic diseases.
Chronic pulmonary aspergillosis, referred to as CPA for short, occurs mainly in people with underlying lung disease, especially those with chronic obstructive pulmonary disease, with high morbidity and mortality. This disease is characterized by pulmonary or systemic symptoms lasting 3 months, weight loss, cough, hemoptysis, imaging examination will find the progression and expansion of lung cavities, precipitin tests show positive serum Aspergillus, C-reactive protein, plasma viscosity, erythrocyte sedimentation rate and other inflammatory indicators increased.
A clever reader may have thought that since Aspergillus invasion of the respiratory tract can cause sputum coughing, is it possible to diagnose the diagnosis through sputum culture? The answer is no. Because sputum culture found positive for Aspergillus, it is not possible to tell whether it is infection or colonization. A complete diagnostic protocol must take into account immune function and associated symptoms. Usually, patients have associated symptoms and imaging changes are found, requiring specific antibody testing. If there are no pulmonary symptoms, nosebleeds or nasal congestion are frequent, a CT scan should be done to rule out sinus aspergillus infection. In addition, when medical conditions permit, the identification of Aspergillus species should be carried out in detail, for example, people with normal immune function, the discovery of Aspergillus fumigatus or Aspergillus aflex, most of which belong to colonization, the discovery of Aspergillus soil requires vigilance.
Diseases caused by Aspergillus infection require antifungal therapy, drug choices such as voriconazole or itraconazole, etc., the course of treatment is usually 6 to 12 weeks, usually imaging and laboratory tests, to determine the absorption of lesions, Aspergillus clearance, immune function recovery, can stop treatment. Finally, we remind everyone that when symptoms such as lung infections occur, we must not only think of bacteria and viruses, but also consider the possibility of fungal infections, and we should be vigilant about Aspergillus infections and diagnose them in time.
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