Medical Microbiology

&Aspergillosisoftherespiratorytract.Anaspergillomaisacircumscribed

“fungusball”thatusuallygrowsinacertainspace(e.g.,acavern).Another

pulmonaryaspergillosisisachronic,necrotizingpneumonia.Acute,invasive

pulmonaryaspergillosisisseeninpatientssufferingfromneutropeniaor

AIDSorfollowingorgantransplantsandhasapoorprognosis.Anotherasper-

gillosisoftherespiratorytractistracheobronchitis.Ofallfungi,aspergilliare

mostfrequentlyresponsibleforvariousformsofsinusitis.Inpersonswith

atopicallergies,asthmamaybecausedbyanallergicaspergillusalveolitis.

&Otheraspergilloses.Endophthalmitiscandeveloptwotothreeweeks

aftersurgeryoraneyeinjuryandtheusualoutcomeislossoftheeye.Cere-

bralaspergillosisdevelopsafterhematogenousdissemination.Lessoften,As-

pergillusspp.causeendocarditis,myocarditis,andosteomyelitis.

Diagnosis.SinceAspergillusisafrequentcontaminantofdiagnosticmateri-

als,diagnosisbasedondirectpathogendetectionisdifficult.Findingthetyp-

icallybranchedhyphaeintheprimarypreparationandrepeatedculture

growthofAspergillusmakethediagnosisprobable.Ifthebranchedhyphae

arefoundintissuebiopsiesstainedwithmethenaminesilverstain,thediag-

nosiscanbeconsideredconfirmed.

Usinglatexparticlescoatedwithmonoclonalantibodies,Aspergillus-spe-

cificantigen(Aspergillusgalactomannan)canbedetectedinbloodserumin

anagglutinationreaction.Antibodiesinsystemicaspergillosesarebest

detectedbyimmunodiffusionandELISA.PCR-basedmethodsdetectAsper-

gillus-DNA.

OpportunisticMycoses(OM) 365

Aspergillusfumigatus

a b

Conidia

Phialides

Vesicle

c^50 μm

Fig.6. 4 a Conidiophorewithconidia(2– 5 lm).

b Y-branched,septatehyphae(1.5– 8 lm).

c Nativepreparation;theconidiahavefallenoff.

6

Kayser, Medical Microbiology © 2005 Thieme