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Aspergillosis - Treatment

Treatment:

A fungus ball is usually not treated (with antifungal medicines) unless there is bleeding into the lung tissue. In that case, surgery is needed.

Invasive aspergillosis is treated with several weeks of an antifungal drug called voriconazole. It can be given by mouth or directly into a vein (IV). Amphotericin B, echinocandins, or itraconazole can also be used.

Endocarditis caused by Aspergillus is treated by surgically removing the infected heart valves. Long-term antifungal therapy is also needed.

Antifungal drugs alone do not help people with allergic aspergillosis. Allergic aspergillosis is treated with drugs that suppress the immune system (immunosuppressive drugs) -- most often prednisone taken by mouth.

Expectations (prognosis):

With treatment, people with allergic aspergillosis usually get better over time. It is common for the disease to come back (relapse) and need repeat treatment.

If invasive aspergillosis does not get better with drug treatment, it eventually leads to death. What happens to a person with invasive aspergillosis also depends on their disease and immune system function.

Complications:

  • Amphotericin B can cause kidney damage and unpleasant side effects such as fever and chills
  • Bronchiectasis (permanent scarring and enlargement of the small sacs in the lungs)
  • Invasive lung disease can cause massive bleeding from the lung
  • Mucus plugs in the airways
  • Permanent airway blockage
  • Respiratory failure

Calling your health care provider:

Call your health care provider if you develop symptoms of aspergillosis or if you have a weakened immune system and develop a fever.

  • Reviewed last on: 6/9/2011
  • David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Jatin M. Vyas, MD, PhD, Instructor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Patterson TF. Aspergillus species. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 258.

Stevens DA. Aspergillosis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 360.

Walsh TJ, Anaissie EJ, Denning DW, et al. Treatment of aspergillosis: clinical practice guidelines of the Infections Diseases Society of America. Clin Infect Dis. 2008;46(3):327-60.

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