&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