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Risk factors
By Mayo Clinic staffYour risk of developing aspergillosis depends on your overall health and the extent of your exposure to mold, but in general, these factors make you more vulnerable to infection:
- Weakened immune system. This is the greatest risk factor for invasive aspergillosis. People taking immune-suppressing drugs after undergoing transplant surgery, especially bone marrow or stem cell transplants, are the most severely affected. In fact, aspergillosis is the leading infectious cause of death among people who have received a heart transplant. People with later-stage AIDS also may be at increased risk.
- Low white blood cell level. White blood cells called neutrophils play a key role in fighting fungal infections. Having a very low level of these cells (neutropenia) due to chemotherapy, an organ transplant or leukemia makes you much more susceptible to invasive aspergillosis. So does having chronic granulomatous disease — an inherited disorder that affects immune system cells.
- Lung cavities. An aspergilloma develops when mold spores germinate in a healed air space (cavity) in your lungs. Cavities are areas that have been damaged by serious lung diseases such as tuberculosis or sarcoidosis — an illness that causes inflammation in your lungs and other organs. The larger the cavity, the greater your chance of developing an aspergilloma. Most often, aspergillomas don't spread beyond the cavity, but when they do, they can cause a cough that brings up blood, and the bleeding may be severe.
- Asthma or cystic fibrosis. Up to 10 percent of people with asthma and cystic fibrosis have an allergic response to aspergillus mold. This is more likely to occur in people whose lung problems are long-standing or hard to control.
- Long-term corticosteroid therapy. Because corticosteroids suppress your immune system, they increase the risk of aspergillosis. Infections that result from corticosteroid use tend to be severe and develop rapidly.
- A hospital stay. Aspergillus mold is found on many hospital surfaces — bedrails, plants, surgical instruments, air conditioning, ducts, insulation — and in the tap water. Though healthy people aren't likely to be affected, people with a weakened immune system or serious illness are highly susceptible to infection. Most major hospital outbreaks have been traced to nearby building destruction and renovation projects, and to contaminated air filters and carpeting.
- Genetics. Genetic factors may make certain people more prone to aspergillosis infection.
References
- Stevens DA. Aspergillosis. In: Goldman L, et al., eds. Cecil Medicine. 23rd ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/126486890-3/0/1492/0.html. Accessed March 15, 2009.
- Aspergillosis. Centers for Disease Control and Prevention. http://www.cdc.gov/nczved/dfbmd/disease_listing/aspergillosis_gi.html. Accessed March 15, 2009.
- Davies SF, et al. Fungal infections. In: Mason RJ, et al. Murray & Nadel's Textbook of Respiratory Medicine. 4th ed. St. Louis, Mo.: W.B. Saunders; 2005. http://www.mdconsult.com/das/book/body/126486890-4/817667210/1288/304.html#4-u1.0-B0-7216-0327-0..50037-9--cesec55_2038. Accessed March 15, 2009.
- Handa S. Aspergillosis. In: Ferri FF. Ferri's Clinical Advisor 2009. St. Louis, Mo.: Mosby; 2008. http://www.mdconsult.com/das/book/body/126486890-5/817668274/1701/64.html#4-u1.0-B978-0-323-04134-8..50004-5--subchapter59_1265. Accessed March 15, 2009.
- Rosenow EC (expert opinion). Mayo Clinic, Rochester, Minn. March 20, 2009.
