In a recent study, spearheaded by a team at the Postgraduate Institute of Medical Education and Research in Chandigarh, researchers determined that patients with non-cystic fibrosis (non-CF) bronchiectasis often had chronic Aspergillus fumigatus infections. According to Bronchiectasis News Today, researchers wondered how sensitization, or frequent exposure, affected patients with non-CF bronchiectasis. Ultimately, they determined that because the rates of chronic infection are so high, patients with non-CF bronchiectasis should be commonly monitored for symptoms or other health issues. Read the full study findings published in Mycoses.

A. Fumigatus

According to Radiopaedia, A. fumigatus is:

a saprotroph (an organism that gets its energy from non-living organic matter) that is widespread in nature, typically found in soil and decaying organic matter. Colonies produce thousands of minute grey-green conidia (2–3 μm) that readily become airborne.

Admittedly, most people inhale hundreds of these fungal spores daily. However, in most cases, a healthy immune system prevents infection and other poor health outcomes. Healthline explains that those most at risk of becoming infected with A. Fumigatus include:

• Those with asthma, cystic fibrosis (CF), or other pulmonary conditions
• People with leukemia, who have received an organ transplant, who are receiving chemotherapy, or who otherwise have a low white blood cell count
• Individuals with HIV or AIDS
• Those taking immunosuppressive therapies or corticosteroids

Symptoms of A. fumigatus infections include:

• Fever
• Muscle weakness
• Fatigue
• Difficulty breathing
• Coughing up brown mucus and/or blood
• Unintended weight loss
• Night sweats
• Ocular inflammation
• Skin lesions
• Seizures

The Research

Researchers wanted to understand whether A. fumigatus sensitization was higher in patients with varied causes of non-CF bronchiectasis, and how sensitization impacted patients. Over a 2-year period, researchers found 258 patients with non-CF bronchiectasis, with a mean age of 42. Patients, on average, experienced symptoms for over 6 years. Research findings include:

• Tuberculosis caused bronchiectasis for 60.1% of patients. The next highest group (25.6%) had idiopathic, or unknown, causes. Those with idiopathic causes, or other causes outside of tuberculosis, had longer-lasting symptoms.
• 76% of study participants had a chronic A. fumigatus infection, while 26% of patients had both a chronic infection and sensitization.
• Having tuberculosis increased the risk of sensitization. Patients with tuberculosis also had more fungal pathogens in their sputum. In groups without tuberculosis, the Pseudomonas aeruginosa bacteria was more commonly found.

Moving forward, researchers suggest routine monitoring and evaluation of A. fumigatus sensitization in patients with non-CF bronchiectasis.

Bronchiectasis

While cystic fibrosis causes about 1/3 of bronchiectasis diagnoses, other lung injuries or illnesses account for non-CF bronchiectasis diagnoses. Additional causes include HIV, allergic fungal lung reactions, inflammatory bowel disease (IBD), and autoimmune conditions. Bronchiectasis causes the damaging, widening, and thickening of bronchial tubes. As the tubes are damaged, bacteria and mucus accumulates in the lungs, causing health issues. Symptoms include, but are not limited to:

• Chronic cough
• Coughing up yellow/green mucus and/or blood
• Shortness of breath / difficulty breathing
• Wheezing
• Unintended weight loss
• Frequent respiratory infections
• Fatigue
• Fingernail and toenail clubbing
• Fever
• Night chills
• Chest pain

Find out more on bronchiectasis.