Experience with "Few Aspergillos Fumigatus"?

@lvnl As I recall, aspergillus fumigatus and others, often are one of those things that may be in one culture, but not the next. With this type of pathogen, whether to treat depends on whether there are "many" If there are "few" or "rare", it might be treated if it appears in multiple, consecutive cultures, or in increasing numbers.
Over the past 8 years, it has appeared twice, in small numbers, both times after another illness. It has never been treated.

Ok so I was diagnosed with aspergillosis fumagatos several years ago via bronchoscopy at UMASS. The doctors were happy - not that I had that, but that it was way more treatable than MAC! I was on Vfend and then Cresemba ( sp). I no longer have that bug in me!! I am grateful I did that treatment. Like you I also have MAC and had RSV and several other lovely “unwanteds”. The fewer things inhabiting my lungs the better as they destroy them!! I want to breathe a bit longer. I have “stuff” to do! Irene5

I have heard Dr. Shelby MacRae, a bronchiectasis expert from LSU, say in a patient seminar that they rarely treat fungus unless it repeatedly appears and seems to be driving inflammation.

I’ve also heard this discussed at professional conferences. Our lungs are dark, warm, and moist environments, so the occasional appearance of fungus may not automatically be cause for concern. From what many specialists explain, it often becomes more relevant when it is persistent, repeatedly shows up in cultures, and other possible causes of worsening symptoms have been ruled out.

Of course, there are situations where fungal disease can become more serious, such as cavitation or the development of a fungus ball (aspergilloma), which may be visible on a CT scan and would need medical evaluation and treatment.

Regards,
Linda Esposito

Thank you for that great information!

Just another reminder of how different our situations can be! My bronchoscopy was a robotic one and the pulmonologist was able to see, within the cavity, the hyphae of the actively growing Aspergillus. In my case there was no question about whether to treat or not.

@smtdoc is a robotic bronchoscopy standard with your doctor or there were special circumstances to have it

I have had at least 5 bronchoscopies but this was the first one that was robotic. I think it was essential because of the need to actually see inside of the small lesions and to obtain specific biopsies rather than the less specific findings with the less invasive regular bronchoscopy. The recommendation was based on the CT scan and you can read the sense of urgency in that the procedure was scheduled within 5 days of the CT.

I was diagnosed with aspergillosis and treated very quickly with Voriconazole. My galactomanin from my bronchoscopy was 4.89. I think that plus the fact that I had a significant hemorrhage in my lung led to the decision to treat. The ID doctor and pulmonologist from Mayo agreed with my local doctors that treatment was necessary. I think whether to treat depends upon clinical results from tests including CT, bronchoscopy, blood and sputum test along with symptoms people present with. These are challenging infections and we are so fortunate to have expert physicians available to help!

I had aspergillus last year. My case was bad enough that I felt quite ill. I was treated with three months of Cresemba and that seems to have cleared it up. The only side effect for me was very uncomfortable constipation.