Medical History and Risk Factors: Aspergillosis

Medical History and Risk Factors your doctor will take into account when diagnosing Aspergillus

1. Medical History

• Inquire about:

  Past medical conditions, especially those affecting the lungs or immune system, recent illnesses, and any known exposures to mold or fungi. 
• Consider:

  Immunocompromised status (e.g., HIV, cancer treatment, organ transplant) as a major risk factor for invasive aspergillosis.  One significant risk factor is a weakened immune system. People with compromised immune systems, such as those with HIV/AIDS, organ transplant recipients, or individuals undergoing chemotherapy, are more vulnerable to Aspergillus infections.

  Another group at risk includes individuals with chronic lung conditions like asthma, cystic fibrosis, or chronic obstructive pulmonary disease (COPD). These conditions weaken the respiratory system, making it harder for the body to fight off fungal infections.

  Ask about:

  Symptoms such as fever, cough, shortness of breath, chest pain, and hemoptysis (coughing up blood). 
• Inquire about:

  Allergic reactions, asthma, or other lung conditions can be relevant for allergic bronchopulmonary aspergillosis (ABPA).  Additionally, those working in specific occupations, such as agricultural workers, construction workers, or those in healthcare settings, may be more exposed to Aspergillus due to their work environment.

2. Physical Examination:

• General appearance: Look for signs of illness, such as lethargy, fatigue, or difficulty breathing. 
• Auscultation (Listening to heart and lungs via stethoscope:) Listen for wheezing, crackles, or other abnormal lung sounds. 
• Palpation: Check for tenderness or masses in the chest or sinuses. 
• Other findings: Note signs of underlying lung disease, such as clubbing in patients with cystic fibrosis, or signs of sinus involvement. (Clubbed fingers refers to the way the ends of your fingers look, including your nails and the areas around and under them)

Clubbing is often associated with chronic low blood oxygen levels, which can be caused by various conditions, including: 

• Cardiopulmonary conditions: Lung diseases (like lung cancer, lung abscess, pulmonary fibrosis, bronchiectasis), congenital cyanotic heart disease. 
• Gastrointestinal conditions: Cystic fibrosis, celiac disease, and other diseases that cause malabsorption. 
• Other conditions: Certain liver disorders, some infections, and in rare cases, it can be hereditary. 

In my case I have had tuberculosis twice and aspergillus was found to be in a cavity in my lungs.  It is called a fungal ball or Aspergilloma see: What is an Aspergilloma?