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Microbiology and Epidemiology
Aspergillus, a mold with septate hyphae branching at 45° angles, has vast numbers of conidia (spores). It has a worldwide distribution and typically grows in decomposing plant materials and in bedding. A. fumigatus is responsible for most cases of invasive aspergillosis, almost all cases of chronic aspergillosis, and most allergic syndromes.
- Inhalation is common; only intense exposures cause disease in healthy, immunocompetent individuals.
- The primary risk factors for invasive aspergillosis are profound neutropenia, glucocorticoid use, therapy with immune modulators (e.g., TNF-α inhibitors, daclizumab, rituximab), and severe liver disease.
- Pts with chronic pulmonary aspergillosis have a wide spectrum of underlying pulmonary diseases (e.g., tuberculosis, sarcoidosis).