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Treatments and drugs
By Mayo Clinic staffAspergillosis treatments vary with the type of disease. Possible treatments include:
- Oral corticosteroids. The goal in treating allergic bronchopulmonary aspergillosis is to prevent existing asthma or cystic fibrosis from becoming worse. The best way to do this is with oral corticosteroids. Antifungal medications by themselves aren't helpful for allergic aspergillosis, but they may be used in combination with corticosteroids to reduce the dose of steroids and improve lung function.
- Antifungal medications. These drugs are the standard treatment for invasive pulmonary aspergillosis. Historically, the drug of choice has been amphotericin B, but the newer medication voriconazole is now preferred because it appears more effective and may have fewer side effects. All antifungals can cause serious problems, however, including kidney and liver damage, and they frequently interact with other medications given to people who have weakened immune systems.
- Watchful waiting. Aspergillomas often don't need treatment, and may simply be closely monitored by chest X-ray. When they cause life-threatening bleeding, the options are limited. Because antifungal medications don't penetrate the fungus ball very well, surgery is the first-choice treatment for this condition. The surgery is risky, however, and your doctor may instead suggest embolization. In this procedure, your doctor threads a small catheter into the artery that supplies blood to the cavity containing the fungus ball, and injects a special material that clogs the artery. Though this procedure can stop massive bleeding, it doesn't prevent it from recurring.
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.
