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| Aspergillosis (Aspergillus) | |
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| Topic Started: Feb 18 2009, 09:42 AM (27 Views) | |
| BUUZBEE | Feb 18 2009, 09:42 AM Post #1 |
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Aspergillosis Description: Aspergillus - The genus Aspergillus includes a variety of related fungi which cause aspergillosis. An important member of this genera is Aspergillus fumigatus. This fungus produces endotoxins which are generally responsible for the disease known as aspergillosis. Aspergillus species are common in the environment. Spores often become airborne in dry windy weather spreading from one location to another. Spores can enter an individual and develop in the respiratory system, lungs, eyes, and ears. Sick Building Syndrome is a condition caused by continuous fungal growth in areas of buildings and ventilation systems. Growth leads to the release of more spores. This can potentially leads to large scale respiratory infections and distress associated with aspergillosis. Aspergillosis can be fatal, especially to those with immunodeficiency. This opportunistic pathogen is common among domesticated and cage birds. *Penicillium notatum and the antibiotic revolution Not all fungi are problematic, in fact some are vital in fighting numerous bacterial infections. In 1941 Albert Alexander had an infection at the corner of his mouth caused by the bacteria Staphylococci and Streptococci. Over time the infection spread to the rest of his face, eyes, and lungs. At the time, two scientists Howard Florey and Earnest Chain had just begun purifying a substance produced by the fungus Penicillium notatum that killed bacteria and was discovered by Alexander Fleming. Albert Alexander's doctor Charles Fletcher knew that Florey and Chain were looking to test this drug on a human volunteer, and so on February 1941 Albert Alexander became the first human treated with penicillin. Within 24 hours of his initial treatment his temperature dropped, his appetite returned and his infection began to heal. -------------------------------------------------------------------------------- Transmission: Inhalation of conidia (spores) from contaminated feed, fecal material, and soil. The spores are often present in the environment and healthy unstressed birds are generally resistant to even high levels of spores. However, young and old birds, birds on antibiotics, and those birds whose immune systems are suppressed by surgery, reproduction, environmental changes, capture, shipping, or age are frequently infected. Aspergillus can also infect the developing embryo by penetrating the egg while the embryo is developing. Infected eggs may develop a slightly greenish tint when candled. Well developed lesions may appear on infected embryos after they hatch. -------------------------------------------------------------------------------- Symptoms: Symptoms range from respiratory distress, gasping, accelerated breathing, voice changes, abnormal droppings, emaciation, regurgitation, poor appetite, diarrhea, anorexia, gout, increased thirst, nasal discharge, conjunctivitis, dyspnea, neuromuscular disease, somnolence, lesions (yellow or gray nodules and/or plaques in the lungs, air sacs, or trachea; less often in the peritoneal cavity, liver or other sites). -------------------------------------------------------------------------------- Prevention: Minimize stress and overcrowding. Provide proper ventilation. Reduce contact with mold or spore contaminated nesting materials. Prevent malnutrition with a proper diet. Make sure feed is properly stored and is free of fungal growth. Aspergillus spores may be present in corn and grain products as well as manufactured pellets or extruded food and may develop into fungal growth if conditions are favorable. -------------------------------------------------------------------------------- Treatment: Antifungal treatment - Amphotericin, Flucytosine, Fluconazole & Itraconazole. Immunostimulants. Surgery may be required with certain localized Aspergillomas. -------------------------------------------------------------------------------- Diagnosis: Tentative diagnosis can be made with clinical signs along with the absence of bacterial infection. A blood test showing an elevation in white blood cell count, mild anemia, and an elevation in the monocytes also supports this diagnosis. X-rays can be taken on any suspect patient. A radiograph can reveal densities or nodules consistent with aspergillomas. Samples of the fungus can also be taken, and cultured in specially prepared culture media. Caution - Apergillus is a common environmental contaminant. PCR and sequence assays to identify the presence of Aspergillus and identify specific strains. -------------------------------------------------------------------------------- Sample: When testing individual birds, a cloacal swab and throat culture is recommended. If the sample tests positive and clinical signs are positive, the bird should be placed in quarantine and aggressive treatment should begin immediately. Environmental testing using swabs of aviaries, countertops, fans, air-filters, nest-boxes etc. is extremely effective in determining the presence of Aspergillus in the environment. Remember Aspergillus is found naturally in certain environments without causing any harm. -------------------------------------------------------------------------------- Handling: Prior to shipping samples should be stored at 4 C. (refrigerator). Samples must be shipped in a padded envelope or box. Samples may be sent by regular mail, but overnight is recommended. -------------------------------------------------------------------------------- Limitations: -------------------------------------------------------------------------------- References: avian biotech |
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| BUUZBEE | Feb 18 2009, 09:46 AM Post #2 |
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Aspergillosis (Aspergillus) from the CDC Frequently Asked Questions What is Aspergillus? Aspergillus is a fungus (or mold) that is very common in the environment. It is found in soil, on plants and in decaying plant matter. It is also found in household dust, building materials, and even in spices and some food items. There are lots of different types of Aspergillus, but the most common ones are Aspergillus fumigatus and Aspergillus flavus. Some others are Aspergillus terreus, Aspergillus nidulans, and Aspergillus niger. What is aspergillosis? Aspergillosis is disease cause by Aspergillus. There are many different kinds of aspergillosis. One kind is allergic bronchopulmonary aspergillosis (also called ABPA), a condition where the fungus causes allergic respiratory symptoms, such as wheezing and coughing, but does not actually invade and destroy tissue. Another kind of aspergillosis is invasive aspergillosis, a disease that usually affects people with immune system problems. In this condition, the fungus invades and damages tissues in the body. Invasive aspergillosis most commonly affects the lungs, but can also cause infection in many other organs and can spread throughout the body. Who gets aspergillosis? ABPA can affect people who are otherwise healthy, but it is most common in people with asthma or cystic fibrosis. Invasive aspergillosis generally affects people who have compromised immune systems, such as people who have had a bone marrow transplant or solid organ transplant, people who are taking high doses of corticosteroids, and people getting chemotherapy for cancers such as leukemia. Rarely, persons with advanced HIV infection can acquire the infection. How is Aspergillus spread? Since Aspergillus is so common in the environment, most people breathe in Aspergillus spores every day. It is probably impossible to completely avoid breathing in some Aspergillus spores. For people with healthy immune systems, this does not cause harm, and the immune system is able to get rid of the spores. But for people with compromised immune systems, breathing in Aspergillus spores, especially breathing in a lot of spores (such as in a very dusty environment) can lead to infection. Studies have shown that invasive aspergillosis can occur during building renovation or construction. Outbreaks of Aspergillus skin infections have been traced to contaminated biomedical devices. What are the symptoms of aspergillosis? There are many different kinds of aspergillosis, causing different symptoms. As mentioned above, ABPA can cause respiratory symptoms like wheezing, coughing and even fever in people with asthma or cystic fibrosis, and occasionally in people who are otherwise healthy. Aspergillus can also cause allergic sinusitis, and it can cause aspergilloma, or a “fungus ball” in the lung or other organs. Lung aspergillomas usually occur in people with other forms of lung disease, like emphysema or a history of tuberculosis. People with an aspergilloma in the lung may have no symptoms at all. Sometimes they may cough up bloody mucus. People who have invasive aspergillosis in the lung may have symptoms such as fever, chest pain, cough, and shortness of breath. Other symptoms may develop if the infection spreads beyond the lungs. When invasive aspergillosis spreads outside of the lungs, it can affect almost any organ in the body, including the brain. How soon do symptoms appear? Incubation time varies depending on host factors and exposure characteristics. If I have symptoms, should I see my doctor? Yes. Invasive aspergillosis is a very serious infection, and early treatment is necessary. How is an Aspergillus infection diagnosed? Your doctor might perform a variety of tests to make the diagnosis. In addition to considering your risk factors, symptoms, and findings on physical examination, your doctor might ask you to have an imaging test performed, such as a chest x-ray or CT scan of the lungs. Also, samples of respiratory secretions or samples from affected tissues may be sent to the laboratory for fungal culture. Biopsies of affected tissue might be taken to look for evidence of the fungus under a microscope. There are other, newer tests that can help monitor for invasive aspergillosis in high-risk persons who are severely immunocompromised. How is invasive aspergillosis treated? Voriconazole is currently first-line treatment for invasive aspergillosis. There are other drugs that can be used to treat invasive aspergillosis in patients who cannot take voriconazole or who have not responded to voriconazole. These include itraconazole, lipid amphotericin formulations, caspofungin, micafungin, and posaconazole. Whenever possible, immunosuppressive medications should be discontinued or decreased. How can Aspergillus infections be prevented? It is almost impossible to avoid all exposure to this fungus. It is present in the environment. However, for persons who are very immunocompromised, some measures that may be helpful include: avoidance of dusty environments and activities where dust exposure is likely (such as construction zones), wearing N95 masks when traveling near dusty environments, and avoidance of activities such as gardening and lawn work. Other air quality improvement measures such as HEPA filtration may be used in healthcare settings, and prophylactic antifungal medication may in some circumstances be prescribed by your doctor. |
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| BUUZBEE | Feb 18 2009, 09:48 AM Post #3 |
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ASK THE VET (Aspergillosis/Part I) by Linda Pesek, DVM Westbury Animal Hospital 319 Union Avenue Westbury, NY 516-333-1123 This article first appeared in SQUAWK, the newsletter of the Big Apple Bird Association, and appears here with permission. Aspergillosis is the most frequently occurring fungal infection in birds. It occurs in acute and chronic forms. The acute form primarily occurs in young birds and newly imported birds and is the result of exposure to a large number of spores. The chronic form is more likely to occur in older birds that have been in captivity. Aspergillosis spores are widespread in the environment and many birds may carry them in their lungs and air sacks until immunosuppression or stress triggers clinical disease. Aspergillosis has been diagnosed in a variety of captive and free-living species of birds. It is characteristically a disease of captivity and close confinement, particularly when birds are kept in an unclean environment. Aspergillosis is most commonly caused by A. fumigatus, although A. flavus, A. niger, A. nidulans, and A. terreus may cause the disease as well. The fungus is ubiquitous in the environment and flourishes in rotting vegetation and decaying organic material. The disease is contracted as the result of inhalation of spores. It may also be contracted by oral ingestion, especially if birds are fed moldy seed. The fungus is also capable of penetrating broken skin and egg shells, and so is able to infect a developing embryo. Susceptibility to aspergillosis is greatly increased in the immunocompromised and malnourished avian patient. Stress pre-existing disease, and the prolonged use of antibiotics and steroids, may further increase a bird's susceptibility. Contaminated food, water, and nesting material are sources of exposure to spores. In birds, aspergillosis is primarily a disease of the lower respiratory tract. Although the lungs and air sacs are usually involved, the trachea, syrinx, and bronchi may be affected as well. Infection can spread from the respiratory tract to pneumatized bone or enter the peritoneal cavity. Any organ can become infected by the fungus. In the acute form, anorexia, dyspnea, or sudden death may occur. White, mucoid exudation, marked congestion of the lungs and air sacs, and pneumonic nodules may be present. In the chronic form, dyspnea, voice change, lethargy, depression, emaciation, polydipsia, and polyuria may occur. Extensive involvement of the respiratory tract can be present before clinical signs are apparent. Ataxia and paralysis occur of the central nervous system is affected. Next time: Diagnosis of Aspergillosis. |
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| BUUZBEE | Feb 18 2009, 09:49 AM Post #4 |
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ASK THE VET (ASPERGILLOSIS - PART II Diagnosis of Aspergillosis) by Linda Pesek, DVM Westbury Animal Hospital 319 Union Avenue Westbury, NY 516-333-1123 This article first appeared in SQUAWK, the newsletter of the Big Apple Bird Association, and appears here with permission. Aspergillosis is the most frequently occurring fungal infection in birds. All species are susceptible. It may be contracted as the result of inhalation of fungal spores or oral ingestion, especially if birds are fed moldy food or housed on contaminated bedding.Immunocompromised and malnourished birds are most susceptible to the disease. Diagnosis of aspergillosis can be difficult. A tentative diagnosis may be made of the basis of physical findings, a history of environmental conditions suitable for fungal growth, and recent stress. A hemogram may show a significant leukocytosis (elevated white blood cell count) with a heterophilia early in the disease. As the disease becomes more chronic, a monocytosis, lymphopenia, and non-regenerative anemia develop. An increase in total blood protein with a hyperglobulinemia may develop. Deep tracheal cytology and culture may be performed under anesthesia. A positive culture will usually be present in 18 hours. A single colony growth is considered significant. Endoscopic examination of the respiratory tract and abdominal cavity will allow cultures to be taken and granulomas (large walled-off areas) visualized. An indirect ELISA blood test will permit the detection of antibodies, which will be present within a week of exposure to a large number of spores. This test permits detection of a patient early in the course of the disease, before clinical signs become apparent. Antibody titers decline during remission, and thus this test is useful in monitoring a patient's response to treatment. Unfortunately, an infected bird may fail to show a positive titer due to a poor immune state. Radiographs may be helpful in supporting a diagnosis of aspergillosis. Hyperinflation of air sacs in the lateral and ventraldorsal views is the classic presentation. This occurs as a result of stenosis near the syrinx or mainstem bronchi which results in the trapping of air in the caudal air sacs. Nodular densities may be present in the air sacs and lungs. Loss of definition of air sac lining may occur early in the disease. Asymmetry of the air sacs as a result of air sac collapse, hyperinflation, or filling with necrotic material may be present. Treatment of aspergillosis involves several objectives: 1. removal of lesions restricting the flow of air through major airways 2. killing and eliminating fungal organisms, and 3. supportive care |
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| BUUZBEE | Feb 18 2009, 09:51 AM Post #5 |
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The Aspergillus Website... The Aspergillus website is a worldwide comprehensive resource providing a wide range of information about the fungus Aspergillus and the diseases such as Aspergillosis that it can cause. This site provides an encyclopaedia of Aspergillus for doctors, scientists, patients and their relatives. Aspergillus is a fungus whose spores are present in the air we breathe, but do not normally cause illness. However an individual with a weakened immune status may be susceptible to aspergillus infection. Aspergillosis is a group of diseases which can result from aspergillus infection and includes invasive aspergillosis, ABPA and aspergilloma. Some asthma patients with very severe asthma may also be sensitised to fungi like aspergillus (SAFS). There is a section devoted to the needs of patients, friends and family suffering from the effects of Aspergillosis. Aspergillosis may affect patients whose immune system may be compromised - including those with Leukaemia, Chemotherapy patients or those on steroids, Transplant patients, Cystic fibrosis, HIV or AIDS, Chronic obstructive pulmonary disease (COPD), Chronic granulomatous disease (CGD), Severe asthma with fungal sensitivity (SAFS) and many others. Sources of increased risk include - dirty air conditioning units, compost heaps and damp or flood- damaged housing, all of which can yield higher numbers of aspergillus spores. Aspergillus does not solely affect humans; birds and animals can also develop aspergillosis, and some plant diseases and food spoilage may be due to aspergillus infection. Visit the Aspergillus blog for news. A multilingual translation of information about aspergillus and aspergillosis is available. |
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