Treatment for Aspergillosis
Treatment for aspergillosis depends on the form and severity of the disease. It may include antifungal medications, surgery, and management of underlying conditions like asthma or TB.
1. Antifungal Medications
- First-line drug: Voriconazole
- Used for invasive aspergillosis and CPA
- Alternatives: Itraconazole, Posaconazole, or Amphotericin B
- Duration:
- Invasive aspergillosis: Usually several weeks to months
- CPA or aspergilloma: May require long-term or lifelong treatment
2. Allergic Bronchopulmonary Aspergillosis (ABPA)
- Corticosteroids (e.g. prednisone) to reduce immune response
- Antifungal drugs (e.g. itraconazole) to reduce fungal burden
- Bronchodilators if asthma is also present
3. Surgery
- Reserved for aspergillomas that cause life-threatening bleeding (haemoptysis)
- Involves removal of the fungal ball and surrounding damaged tissue
- High-risk in patients with poor lung function
4. Adjunct Therapies
- Oxygen therapy for advanced CPA
- Nutritional support
- Treating underlying conditions (e.g. TB scarring, HIV)
5. Monitoring
- Repeat CT scans or X-rays to monitor progression
- Regular liver function tests during antifungal treatment
In South Africa, antifungal therapy is available through tertiary hospitals and some provincial TB units. Access to newer antifungals like voriconazole is improving, though cost may limit availability in some settings.
Let’s now look at potential complications.
👉 [Next: Complications of Aspergillosis]
