1. Aspergillosis is a group of diseases caused by the Aspergillus fungus. Some asthma patients are sensitized to the fungi Aspergillus. 2. Aspergillus fumigatus is one of the most common Aspergillus species that causes disease in immunocompromised individuals and people with leukemia. It is typically found in soil and decaying organic matter. 3. Aspergillosis is classified as invasive, chronic, or allergic depending on symptoms and disease progression. Invasive aspergillosis can disseminate and involve multiple organs while allergic aspergillosis includes conditions like allergic bronchopulmonary aspergillosis

1. SUBMITTED BY
AM.RAJHA VIKNESH
(12UMB17)
III BSC,MICROBIOLOGY

2. Submitted to
Mrs.s.shahitha
Asst professer
Dept of microbiology
Mcas,rasipuram

4. WHAT IS ASPERGILLOSIS?
 ASPERGILLOSIS IS A GROUP OF DISEASE CAUSED
BY THE ASPERGILLUS FUNGUS
 SOME ASTHMA PATIENTS ARE SENSITIZED TO
FUNGI ASPERGILLUS
 THIS CONDITION IS SEEN IN
IMMUNOCOMPROMISED INDIVIDUAL AND
PERSONS WITH LEUKAEMIA

5. Aspergillus
aspergillum, which resembled the genus-characteristic
conidia-forming structure of these fungi.
Aspergillus is an extremely diverse and widely distributed
genus of filamentous ascomycete fungi.
It includes over 200 species of mostly asexual fungi found
ubiquitously In soil as well as in forage products, food,
dust, organic debris, and decomposing vegetation.
Being supreme opportunists, the aspergilli have adapted to
various chemical, physical, and biological stresses and have
repeatedly changed their lifestyle and reproductive mode
in the course of evolution.

6. Hierarchy of A.fumigatus

7. Aspergillus
While most of them are thought to be saprophytes.
The Aspergillum number of species are able to infect
wounded plants and animals.
The advent of immunosuppressive agents and other
medical advances created a new biological niche for
aspergilli, the immunocompromised human host.

8. Aspergillus fumigatus
Aspergillus fumigatus is a fungus of the genus
Aspergillus, and is one of the most common
Aspergillus species to cause disease in individuals with
an immunodeficiency.
A. A.fumigatus, a saprotroph widespread in nature, is
typically found in soil and decaying organic matter,
where it plays an essential role in carbon and
nitrogen recycling.
B. A. fumigatus is a well-known pathogenic fungus that
is responsible for more than 80% of aspergillosis,
especially in immunocompromised patients.

9. Caustive fungi of Aspergillosis
Aspergillus fumigatus in microscopic view

10. CLASSIFICATION OF ASPERGILLOSIS
INVASIVE ASPERGILLOSIS:
* Acute (<1 month course)
* subacute/chronic necrotising (1-3mon).
CHRONIC ASPERGILLOSIS: (>3MON)
*Chronic cavity pulmonary
*Aspergilloma of lung
*Chronic fibrosing of lung
*Chronic invasive sinusitis
*Maxillary (sinus)aspergillomma

11. CLASSIFICATION OF ASPERGILLOSIS
ALLERGIC:
*Allergic bronchopulmonary(ABPA)
*Extrinsic allergic (broncho)alveolitis(EAA)
*Asthma with fungal sensitisation
*Allergic aspergillus sinusitis(eosinophilic
fungal rhinosinusitis)

12. Clinical features in aspergillosis
ASPERGILLOMA:
Here a fungal ball grows within
and is usually restricted to an existing lung
cavity
For example,Due to an old tuberculosis or bronchiectasis.
In this type of colonising aspergillosis surgical removal is necessary it
causes massive hemoptysis

13. Clinical features in aspergillosis
INVASIVE ASPERGILLOSIS:
This first causes pneumonia
and later disseminates to involve other organs,
For Ex: the brain , kidneys or heart
Patients who develop this type of disease,which may
be fatal,are usually immunocompromised or
debilitated due to prolonged treatment with
antibiotics,steroids and cytotoxic drugs.

14. Clinical features in aspergillosis
SUPERFICIAL INFECTION:
Superficial infections of the
external ear(otomycosis) the eye (mycotic keratitis)
and nasal sinuses

15. SECONDARY INFECTION
 CHEMOTHERAPHY PATIENTS
 TRANPLANT AND STEROID USING PATIENTS
 CYSTIC FIBROSIS
 AIDS
 CHRONIS OBSTRUCTIVE PULMONARY
DISEASE(COPD)
 CHRONIC GRANULOMATIS DISEASE(CGD)
 SEVERE ASTHMA WITH FUNGAL
SENSITIVITY(SAFS)

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17. LAB DIAGNOSIS
MICROSCOPY:
In LCB wetmount,
Specimen:
Exudates
For ex: sputum

18. LAB DIAGNOSIS
Interpretation:
Demonstrate of septate
hyaline hyphae

19. LAB DIAGNOSIS
Gomori methenamine silver staining:
The processed tissue is used as specimen for
gomori methenamine silver stain
This gives the fungal walls a gray black
colour

20. LAB DIAGNOSIS
Immunoperoxidase stain :
Immunostaining was performed on
formalin fixed, paraffin wax embedded tissue using the
streptavidin-biotin method and compared with
conventional haematoxylin and eosin, periodic acid-
Schiff, and Gomori-Grocott stains. Results of
immunostaining were semiquantitatively analysed
with regard to both intensity of staining and number
of positively staining micro-organisms.

21. LAB DIAGNOSIS
Immunoperoxidase staining using the monoclonal
antibody EB-A1 performs well on routinely processed
tissue sections and permits detection and generic
identification of Aspergillus species, although it was
no better than conventional histopathology in
identifying the presence of an infection

22. LAB DIAGNOSIS
ISOLATION BY CULTURE:
In sabouraud
dextrose agar,A.fumigatus
produce velvety to powdery
surface and dark green
Coloured
Incubation period:
3-4 days incubation at 25ᶱ -
37ᶱc

23. LAB DIAGNOSIS
SEROLOGY:
precipitating antibodies to aspergillus
antigens can be demonstrated by counter –current
immunoelectrophoresis,immunodiffusion and ELISA
Antibodies are usually absent in the sera of
healthy individuals .
They can be detected in majority of patients with allergic
aspergillosis and approximately the same proportion
of those with pneumonia or invasive disease

24. LAB DIAGNOSIS
SKIN TEST:
Skin test reactions which develop after the
intradermal injection of Aspergillus species antigens
are important criteria to establish a diagnosis of
allergic broncho pulmonary aspergillosis
Test are two based on the time of
immune response:
*dual immediate-after 15 minutes
*Arthus type-after 4-6 hrs

25. LAB DIAGNOSIS
Collection of BAL:(broncho aleveolar lavage)
Bronchoalveolar lavage (BAL) is
a medical procedure in which a bronchoscope is
passed through the mouth or nose into thelungsand
fluid is squirted into a small part of the lung and then
collected for examination. BAL is typically performed
to diagnose lungdisease. In particular, BAL is
commonly used to diagnose infections in people
with immune system problems, pneumonia in people
on ventilators, some types of lung cancer, and scarring
of the lung (interstitial lung disease).

26. BAL

27. LAB DIAGNOSIS
Galactomannan test: Invasive aspergillosis occurs in about 10% of
stem cell transplant patients and 5% ofsolid organ transplant
patients.
Diagnosis often is difficult and antifungal therapy is usually
initiated empirically, based upon fever and abnormal findings on
chest CT.
Typically the diagnosis is not proven by histopathology or culture.
If treatment is targeted for invasive aspergillosis, and the patient
has zygomycosis or another mold infection, it may not be
effective.
Thus, tests to assist in the accurate diagnosis of invasive
aspergillosis may improve outcome.

28. LAB DIAGNOSIS
Also, a test that assists in early diagnosis may improve
outcome by permitting treatment before the infection
becomes irreversible . Furthermore, a test that indicates
that invasiveaspergillosis is unlikely may alert the physician
to modify therapy or to pursue additional diagnostic
procedures.
The test is primarily used for monitoring immunosuppressed
patients for development of galactomannan antigenemia,
as an early marker for invasive aspergillosis.
The test also is usedfor diagnosis of suspected cases of
invasive aspergillosis.

29. LAB DIAGNOSIS
The sensitivity for diagnosis on pulmonary invasive
aspergillosis may be improved by testing bronchoalveolar
lavage (BAL)specimens.
Although the assay has its limitations, it is useful and
complements other diagnostic method
In hemotologic patients withinvasive aspergillosis the
galactomannan test can make the diagnosis in a
noninvasive way.
False positive aspergillus galactomannan test have been
found in patients or intravenous treatment with some
antibiotics or fluids containing gluconate or citric acid as
some transfusion platelets or parentral nutrition

30. LAB DIAGNOSIS
Imaging test. A chest X-ray or computerized
tomography (CT) scan — a type of X-ray that produces
more-detailed images than conventional X-rays do —
can usually reveal a fungal mass (aspergilloma), as well
as characteristic signs of invasive and allergic
bronchopulmonary aspergillosis.
On chest xray and CT scan ,pulmonary aspergillosis
manifests halosign and later an air crescent sign

31. LAB DIAGNOSIS
X ray:
x ray used to recognise
the area of inflammation
and the cloudiness
Represents the
hemopytic activity

32. LAB DIAGNOSIS
CT scan:
This computer tomography
report is also reveal the
aspergillosis

33. Pathogenicity
Aspergillus spores are ubiquitous in nature and also a
normal flora.
It turns into opportunistic fungi when an individual is
immunocompromised this makes platform for
aspergillus to create mycoses

34. Pathogenicity
The spore enter the human through nostrils and reaches
the lungs
In lungs it gets multiplied and cause suffocationin
breathing.
When it get severe the ball like sputum structure will
expelled from mouth or nose.
It can able to grow in bonemarrow and alveoli of lungs

35. Pathogenicity

36. Antigenic structure of A.fumigatus
A. fumigatus has 23 allergenic proteins. Thermoto
proteins have diversity of functions e.g.ribotoxin,heat
shock protein)
IgE can bind to multiple sites
within a specific protein

37. Lovastatin: Toxins detract from the quality of human
life, some of the products of Aspergillus metabolism
have made positive contributions to the human health
as drugs.
aflatoxin: It cause human liver cancers. Acute human
afl atoxin poisoning, however, is rare and usually only
occurs when starvation forces people to subsist on
moldy foods.

38. SPECIAL CASE
This species is only known to reproduce by asexual means,
but there has been accumulating evidence for
recombination and gene flow from population genetic
studies, genome analysis, the presence of mating-type
genes and expression of sex-related genes in the fungus.
Here we show that A. fumigatus possesses a fully functional
sexual reproductive cycle that leads to the production of
cleistothecia and ascospores, and the teleomorph
Neosartorya fumigata is described. The species has a
heterothallic breeding system; isolates of complementary
mating types are required for sex to occur.

39. SPECIAL CASE
We demonstrate increased genotypic variation resulting from
recombination between mating type and DNA fingerprint
markers in ascospore progeny from an Irish environmental
subpopulation.
The ability of A. fumigatus to engage in sexual reproduction
is highly significant in understanding the biology and
evolution of the species. The presence of a sexual cycle
provides an invaluable tool for classical genetic analyses
and will facilitate research into the genetic basis of
pathogenicity and fungicide resistance in A. fumigatus,
with the aim of improving methods for the control of
aspergillosis. These results also yield insights into the
potential for sexual reproduction in other supposedly
‘asexual’ fungi.

40. References:
www.mycologyonline.com
www.wikipedia.com
www.ncbi.com
www.jcp.com
www.microrao.com
www.uocls.com
www.medlab.com
www.googleimages.com