Please note: While some information will still be current in a year, other information may already be out of date in three months time. If you are in any doubt, please feel free to ask.

Aspergillas

Question
What is the recommended medical treatment to get rid of mold in someone's lungs with CF
Answer
Dear questioner,
let me cite a former answer on this topic from Dr. Posselt, that answers your question, please find another helpful link at the end of the answer:
“Hello,
In CF patients it can be detected more frequently with increasing age mildew in the sputum. These are mostly Candida albicans or Aspergillus fumigatus. Both fungi live in the environment, Candaida albicans especially also on the skin of many people.
The sole detection of Aspergillus fumigatus in the throat swab or sputum is regarded in CF patients in general not as probelmatic and necessary to treat.
In some patients a so-called "allergic bronchopulmonary Aspergillosis (ABPA)" delvelops. Hereby it is an allergic reaction of the patient to the colonization with the fungus. The involved patients are often apparent with a sudden increased cough, a narrowing of the bronchi and an obvious worsening of the lung function. The laboratory investigation shows an strong increase of the Immunoglobulin E and so-called precipitins which give a hint to the allergic reaction. In the thorax x-ray round shadows can be seen, which do often change the localization rapidly when doing a control.
Such an allergic bronchopulmonary aspergillosis is classically treated with cortisone. At the moment there are studies done, in which such a cortisone therapy is combined with a drug, that kills the fungi directly (e.g. Itraconazloe). In such ABPA relapses are not seldom.
As a second form of infection with Aspergillus fumigatus the development of invasively growing Aspergillomas are seen in people with a disturbed immunity. This can e.g. occur in CF patients after a lung transplantation.
Such Aspergillomas can be indentified easily by an experienced radiologist in the CT-scan of the lung. In such a case an intensive infusion therapy is necessary - in general with a combination of 2 drugs which kill the fungi.
Aspergillus fumigatus is as a mildew widely spread in the nature and can be found in high concentrations e.g. in humid leaves, in the flooring of horse-riding halls, in humid straw in horse and cow stables.
In order to avoid a careless infection with Aspergillus fumigatus, playing in mountains of leaves as well as stays in horse-riding halls, horse and cow stables should be avoided.
Yours sincerely,
Dr. H.-G. Posselt“
Another helpful Q/A can be found here:
ecorn-cf.eu/index.php?id=65&L=8&tx_expertadvice_pi1[showitem]=124&tx_expertadvice_pi1[search]=

Hope this helps,
Best regards,
Dr. Daniela d’Alquen (Coordinator of the Central English Archive of ECORN-CF)
25.03.2014
The answer is edited by: PhD Lisa Kent