Clinical information: Moulds of the genus Aspergillus are present in the air and soil, but also in biological waste and contaminated foods. Within the genus, which encompasses more than 300 species, some may lead to infections in humans, given the respective predisposition. Here, Aspergillus fumigatus plays an especially important role. Infections with other species such as A. flavus, A. niger, A. terreus were also described. Transmission occurs via inhalation of spores, of which humans inhale up to several hundred every day. In patients with an intact immune system, this intake does not lead to an infection since the spores can be controlled by the cellular immune system. In the beginning, a permanent load may cause hypersensitivity or allergic reactions (allergic bronchopulmonary aspergillosis, ABPA). With existing lung damage, e.g. destructed lung tissue due to tuberculosis, an aspergilloma, that is, a tumour-like growth may develop.

In patients with weakened immune system or immunosuppression, infections often lead to invasive aspergillosis. Initially, this manifests mainly in the respiratory tracts and the sinuses, but may also disseminate haematogenically and consequently affect organs such as the brain, liver and kidneys. This is usually accompanied by unspecific symptoms such as high fever and inflammation of the affected organs and may affect the central nervous system. Especially haemato-oncological and bone-marrow-transplanted patients are mostly affected. However, also other immune deficiencies, e.g. due to HIV infections or treatments with glucocorticoids, may favour an infection. In the last years, an increasing number of nosocomial infections were observed in patients in intensive care units. According to studies, up to 20% of the group of bone-marrow-transplanted patients were affected by an invasive fungal infection. Here, aspergilloses and candidiases are the most relevant infections. Depending on the manifestation, 50 to 90% of invasive aspergilloses are fatal.

Diagnostics: The laboratory diagnostic detection is based on cultivation or microscopy. However, cultivation is only successful in 50% of cases. The detection of Aspergillus antigen from body fluids is nowadays an established additional method. This enables the sensitive Aspergillus detection already at an early stage. Due to this reason, detection of Aspergillus antigens was included in the guidelines of the European Organization for Research and Treatment of Cancer (EORTC) and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (MSG) as a criterion of a “probable” invasive aspergillosis. Established test systems are based on the detection of polysaccharides from the cell wall.

ProductAnalytOrder number
Aspergillus antigenGalactomannoproteinEQ 6911-9601