What Is Aspergillosis?

Medically Reviewed by Paul Boyce, MD on June 22, 2024
Written by Paul Frysh
3 min read

Aspergillosis is an infection caused by a type of mold called aspergillus. It usually affects your lungs.

The mold that causes it, aspergillus, is quite common. You can find it everywhere, indoors and out. It’s in soil and rotted plants. It’s even in a lot of home insulation, carpeting, air conditioning ducts, and dust. You’ll also find it in certain foods, like dried fish, as well as in marijuana.

Tiny bits of the mold, called spores, float in the air. Most of us can breathe in these spores without any problem.

But if you’re already sick or have problems with your immune system because of certain illnesses or medications you take, you can get aspergillosis. It isn’t contagious though, so you can’t give it to or catch it from someone else.

The symptoms depend in part on the type of aspergillosis you have.

Allergic bronchopulmonary aspergillosis (ABPA). People who get this usually already have asthma or cystic fibrosis. It starts as an allergic reaction with allergy-like symptoms that don’t respond to typical asthma medications, such as:

Less common symptoms include:

In more serious cases, the mold can cause an infection. It doesn’t usually spread to other body parts, but without treatment, it can lead to:

  • Asthma that doesn’t go away
  • Widened bronchial tubes
  • Loss of lung function

Chronic pulmonary aspergillosis. An aspergillosis infection is considered chronic after about 3 months. Possible symptoms include:

  • Thickened tissue around the lungs (pleural thickening)
  • Scarred lung tissue (fibrosis)
  • Empty spaces inside the lung tissue (cavitation)

Chronic pulmonary aspergillosis can lead to aspergillomas, also known as or fungus balls or fungal balls. These slow-growing tangled balls are made up of mold fibers, mucus, white blood cells, and bits of clotted blood. They form in air pockets in your lungs and get bigger over time. They may not cause symptoms for years, but you could notice:

Invasive aspergillosis. This type usually affects people who have a weakened immune system because of an organ or bone marrow transplant. The infection typically starts in your lungs, but travels through the blood to other organs like your kidneys, heart, brain, and skin. Symptoms can vary depending on which organ is affected, but you could have:

  • Fever that doesn’t improve with antibiotics
  • Chest pain that worsens with big breaths
  • Dry cough
  • Aspergilloma
  • Coughing up blood (possibly from aspergilloma)
  • Breathing problems

In severe cases, you might also have:

  • Nosebleeds
  • Sores (ulcers) inside your mouth or inside your chest wall
  • Swelling on one side of eye
  • Trouble talking or moving face muscles

Your doctor will ask about your medical history, illnesses, and symptoms and do a physical exam. They may also need:

  • A sample of fluid or mucus from your airway to test for mold
  • Imaging tests like an X-ray or CT scan of your lung or affected area
  • A sample of lung tissue (or affected area) to test for mold
  • A blood test for invasive aspergillosis

If your aspergillosis results from an allergic reaction, the doctor might consider medications like corticosteroids or simply take a wait-and-see approach.

If you have an infection, you’ll likely need antifungal drugs like isavuconazole, itraconazole, posaconazole, or voriconazole. The doctor will also treat any immune problems by adding or changing medication. You might need to stop taking immune-suppressing drugs like corticosteroids.

Aspergillomas don't usually respond to drugs. In some cases, you may need surgery to remove them.