Invasive Aspergillosis

Key facts

• Invasive aspergillosis is a severe infection caused by the mould Aspergillus, most often A. fumigatus. It typically starts in the lungs and can spread to the sinuses, brain, or other organs.
• It almost exclusively affects people with significantly weakened immune systems: those having chemotherapy, organ transplant recipients, and patients on high-dose corticosteroids.
• Voriconazole is the established first-line antifungal, usually continued for weeks to months and guided by imaging and clinical response.
• Urgent medical assessment is needed if symptoms suggesting a fungal infection develop in someone who is immunocompromised.

Who is at risk and how it develops

Healthy people inhale Aspergillus spores constantly and clear them without ever falling ill. In someone with a weakened immune system, the spores germinate instead and invade lung tissue. Symptoms often look like a chest infection that doesn't respond to antibiotics: persistent fever, cough, chest pain, and occasionally coughing up blood. As the infection spreads beyond the lungs, confusion or focal neurological signs can appear. Environmental mould exposure varies a great deal from place to place, which matters for transplant units and haematology wards managing patients at the highest risk.

Treatment

Invasive aspergillosis needs prompt antifungal therapy. Voriconazole is the established first-line agent, part of the wider antifungal medicine class. Treatment typically runs for weeks to months, with imaging and clinical response guiding how long it continues. Because the infection can progress quickly in a compromised immune system, starting treatment early makes a real difference to outcomes.

When to seek help

Anyone who is immunocompromised, through chemotherapy, transplant medicines, or long-term steroids, and develops a persistent fever, cough, or chest pain that isn't improving should get urgent medical assessment. Early recognition and treatment are the biggest factors in surviving invasive aspergillosis.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.