Aspergillus Mushroom Disease
Aspergillus fungus is one of the largest fungal strains, present in all over the world, there are about 100 species, currently there are about 20-30 species that cause disease in humans, important strains are A. fumigatus, A. flavus , A
.terreuss cause dermatitis in the legs, hands, inflammation around the nail; A.keratitis causes keratitis; Especially A.fumigatus and A.flavus often cause pneumonia.
Aspergillus fungus lives on the soil, producing billions of spores flying in the air, people with immunodeficiency (HIV / AIDS, cancer, chemotherapy, prolonged glucocorticoides
The pathogen of Aspergillus is that it can first cause skin disease then progress to systemic disease or vice versa.
2 Clinical symptoms:
- Skin: The lesions are reddish masses, sometimes forming flaky white macules like tinea versicolor, or polymorphic, like tinea. In some cases, there are eruptions, warts, abscesses or skin sores. People with AIDS often have A.fumigatus and A.flavus that cause fungal infections of the skin and head.
- Ear: fungus often causes disease in the ear canal, the ear canal is swollen, scaly appears much, moisture is very itchy.
. Fungus can spread to the ear canal, or into the eardrum. If not treated promptly, it will cause a hole in the eardrum Aspergillus fungus also causes sinusitis.
- Eyes: Aspergillus often causes eye sockets that spread to the eyeballs causing corneal ulcers, conjunctivitis and lacrimal glands.
- Nervous system: through the cavities in the face or the cranial cavity, fungi can enter inside causing cerebellum inflammation, brain.
- Tongue: 'black hairy' tongue disease, the tongue mucosa is often black with black cilia.
- Heart: often causes endocarditis, myocarditis.
- Bones: osteomyelitis, meningitis
- Urinary system: mainly causes cystitis, ureteritis.
- Pneumonia: in the lungs, the first often causes bronchitis with many symptoms of sputum secretion, wheezing, in the bronchial fluid there are many fungal cells, patients often have fever, shortness of breath, cough, pale confusion leading to pneumonia with symptoms similar to tuberculosis. Patients can lead to pleurisy, pleurisy, and then spread to the heart.
In addition, mushrooms can grow in an existing cave to form a mushroom fungus (funguns ball) in the cheese.
- Allergic asthma caused by Aspergillus: when breathing in the spores in the air often causes allergic bronchial asthma symptoms such as difficulty breathing, fever, dry cough, weight loss, and lung.
-Directly: Specimens are skin scales or pus, sputum ..., small KOH 20%, stained gram, under KHV look for mycelium, spores. Fungal mycelium, double branching, angle of branch and main filament is 45 degrees, clear colored partition ± see small spores, diameter 3-4µm, rough shell, sometimes visible organ Fungi of mushrooms If you are an organ fungus, you need a biopsy to diagnose histopathology, PAS staining, Methenamine silver.
- Cultured: Sabouraud medium at room temperature, colonies grow after 4-5 days, the color depends on the pathogen (black, blue, yellow, orange, white.
. A.fumigatus gives dark green then blue), there is always a white border due to the growing hyphae but there are no spores. Mycelium is baffled, has sporangia, and sporangia are attached with spores attached.
4. Differential diagnosis:
In the skin, it is necessary to make a differential diagnosis with insect rashes, pyoderma and other fungal skin diseases.
Systemic Aspergillus should be distinguished from blastomycosis, histoplasmosis, coccidioidomycosis ..
-Amphotericine B PIV 1mg / kg / day or aerosol, with low effectiveness.
-Itraconazole 400mg / day, effective in 62% of the spread and 44% in the tumor form.
-Aspergillus tumor: surgical removal.
Patients need to visit specialized medical facilities for testing and treatment.
Attention not to self-treat leads to oily drug and digestive complications
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