Chronic pulmonary aspergillosis (CPA) is a fungal infection of the lungs that’s caused by Aspergillus, a common type of mold. People who have chronic lung conditions, such as emphysema, bronchitis, or tuberculosis, are most at risk of developing CPA.
Chronic pulmonary aspergillosis (CPA) is a serious and long-term fungal infection that affects the lungs. Aspergillus, the mold that causes CPA, is commonly found in households, workplaces, and public spaces, as well as in outdoor areas.
This mold isn’t harmful to most people, but it can lead to CPA if your lungs or immune system are already weakened from other conditions. CPA is not contagious. It cannot be passed from person to person.
Treatment may help stop the progression of the condition, alleviate symptoms, and prevent complications.
Aspergillus mold causes CPA. This mold is very common and hard to avoid. It’s found both indoors and outdoors. For example, decaying autumn leaves and compost piles are sources of Aspergillus mold.
Most strains of Aspergillus mold are harmless, and your immune system can destroy them when they’re inhaled. However, people with a weakened immune system or people with chronic lung conditions can contract some strains, which cause an infection.
Some chronic lung conditions can lead to the formation of air spaces (cavities) in the lungs. If someone who has lung cavities develops an Aspergillus infection, the fungus can get into these cavities.
Lung conditions that can put you at risk of CPA include:
Over time, the fungus can grow and form clumps or masses known as aspergillomas in the lung cavities. This can lead to serious complications.
CPA doesn’t always cause symptoms in the early stages. When symptoms do occur, they can vary from person to person. The most common symptom of CPA is coughing up blood.
Other symptoms can include:
A CPA diagnosis begins with a medical appointment. Sometimes based on symptoms, CPA can be initially mistaken for another condition, such as tuberculosis. The doctor will likely order multiple tests to rule out other conditions and to help confirm the diagnosis.
Diagnostic tests for CPA may include:
- Imaging tests: Imaging tests, such as chest X-rays and CT scans, can help the doctor see if there are fungal masses present inside your lung cavities.
- Sputum culture: A healthcare professional uses a sputum culture to examine mucus you cough up to check for the presence of Aspergillus mold.
- Blood tests: These tests aid the doctor in looking for antibodies to Aspergillus mold in your blood.
- Skin tests: For a skin test, a small amount of Aspergillus antigen is injected into your skin to check for antibodies. If you have antibodies, a hard red bump will form at the site.
- Biopsy: Sometimes a lung or tissue sample is needed to confirm a CPA diagnosis.
For most people, CPA is a lifelong condition, and long-term management is needed. However, for a small number of people, CPA may sometimes resolve completely.
The most serious complication of CPA is bleeding in the lungs. Severe bleeding in the lungs can be fatal. One of the primary treatment goals is preventing this complication.
CPA treatment may include:
- Observation: Sometimes no immediate treatment is necessary, especially if you don’t have symptoms. Your doctor may order X-rays or CT scans of fungal masses and set up a schedule to continue monitoring your condition.
- Antifungal medications: Antifungal medications are the most common treatment for CPA. There are several different antifungals that may be used. Your doctor will determine which antifungal medication is best for you based on your medical history, any other medications you may be taking, and the severity of your symptoms.
- Embolization: Embolization is a procedure that uses a catheter (long, flexible tube) inserted into an artery and fed toward the suspected area of bleeding. A dye is injected through the catheter to help identify the bleeding vessel. A coil is then injected into the bleeding vessel to block off blood flow and stop the bleeding.
- Surgery: Surgery is an option to remove the fungal mass. This is done when CPA causes bleeding in the lungs.
The outlook for people with CPA is highly individual. It can vary based on many factors, including your age, other chronic health conditions, disease severity, and how soon treatment was started.
For about 10% of people, the disease may clear up on its own. For most people, though, CPA is a lifelong condition. However, treatment may stop or slow down the progression of symptoms and prevent complications. For some people, CPA may progress, despite treatment.
It’s important to talk with your doctor about your individual outlook and what you can do to prevent complications.
CPA is a chronic lung condition that Aspergillus, a common mold, causes. Aspergillus isn’t harmful to most people, but it can cause CPA if your lungs or immune system are weakened from other conditions.
CPA causes mold masses to build up in the lung cavities. These masses can cause bleeding in the lungs. If the bleeding becomes severe, it can be fatal.
Treatment can vary depending on the severity of symptoms and any underlying conditions, but it commonly includes antifungal medications. Other treatment options may include embolization or surgical procedures to stop bleeding in the lungs.
The treatment plan specifics are based on an individual’s situation and medical needs.