The chronic forms of aspergillosis (i.e. those suffered by people with a normal immune system) can last many years so maintenance is an important issue. All are the result of the fungus gaining a foothold in part of the body and growing slowly, all the while irritating the surface of the delicate tissues they come into contact with, and this can cause changes to the tissues concerned.
Most of these types of aspergillosis affect the lungs and sinuses. As far as the lungs are concerned the delicate tissues irritated by the fungus are important to us to allow us to breathe. These tissues must be flexible in order to stretch as we breathe in, and thin in order to allow efficient exchange of gases to and from the blood supply which runs just below the membranes.
Irritation causes these tissues to inflame and then to thicken and scar - a process which makes the tissues thick and inflexible.
Doctors try to manage this process firstly by diagnosing as early as possible - something that has been difficult in the past but is starting to get easier with the new technology starting to become available.
The next most important thing is to reduce or prevent inflammation, so steroids are prescribed. The dose is often varied by the doctor according to symptoms (N.B. NOT something to attempt under any circumstances without your doctor's agreement) in an attempt to minimise the dose. Steroids have many side effects and minimising the dose also minimises those side effects.
Antifungals such as itraconazole, voriconazole or posaconazole are also often used as although they cannot eradicate the infection they do reduce symptoms quite markedly in many cases. The dose of the antifungal is also minimised to prevent side effects but sometimes also to minimise cost, as antifungals can be very expensive.
Some patients will find themselves on antibiotics from time to time as bacterial infections can be a secondary form of infection in chronic aspergillosis.
What can you do to help yourself?
The patient themselves can contribute to the management of their own illness. Those with allergic forms of the disease will know that avoiding the source of aspergillus spores is important, and that can be found in some very unexpected places e.g. the pillows on your bed can be a prime source of fungal spores, as can your pets (dogs, cats, birds) and other animals you come into contact with e.g. at wildbird feeders as well as house plants.
Vacuum cleaning can be a very effective way of disturbing spores in the carpet and making them fly up into the air to be breathed in. Vacuum cleaners are available in all high street stores fitted with HEPA-grade filters which will help prevent this.
Gardening is fraught with potential sources of spores (e.g. in the soil, in compost, in bark mulches). Avoiding gardening might be best for some, but for many wearing a suitable HEPA-grade face mask will help cut out exposure to fungi while they are working in the garden.
Maintaining good health
A-Z of coping with aspergillosis
Written from experience by patients, access it here.
Aspergillus in pillows
Feathers not as good as synthetic, wash and renew regularly. Read article here.
Aspergillus in the home
Hazards to health in the home