[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Microbiology](https://durgical.com/en/microbiology/) › [Molds and dermatophytes](https://durgical.com/en/microbiology/groups/molds-and-dermatophytes/) › Aspergillus fumigatus [Microbiology](https://durgical.com/en/microbiology/) · [Molds and dermatophytes](https://durgical.com/en/microbiology/groups/molds-and-dermatophytes/) # Aspergillus fumigatus - Fungus - Exam priority: medium A mold of air, dust and soil; it causes allergy in asthma, fungus balls in old cavities and invasive pneumonia in patients without neutrophils. Updated 2026-11-01 Also called: Aspergillus ## Key points - Thin, septate, acute-angle hyphae - Three faces: allergy (ABPA), fungus ball in a cavity and invasive disease in neutropenia - Galactomannan and the CT halo sign - Voriconazole first choice for invasive disease - WHO 2022: A. fumigatus is in the critical group of priority fungi ## At a glance **Shape** Thin septate hyphae branching at acute angles **Family** Aspergillaceae (Eurotiales) **Type** Hyaline mold (filamentous fungus) **Stain** Silver (GMS) and PAS in tissue; lactophenol blue in culture **Size** Hyphae about 3–6 µm wide ## Morphology - Thin hyphae with regular septa, branching at acute angles (about 45°) - In culture: a conidiophore with a vesicle bearing chains of conidia - Fast-growing blue-green colonies - Tolerates high temperatures ## Transmission - Inhaling conidia present in air, dust, soil, plants and building works - Not spread from person to person or from animals to people **Reservoir:** Soil, decaying plant matter, dust and building materials ### Isolation precautions What the care team adds to standard precautions. - Standard ## Virulence factors - Small conidia that reach the alveolus - Invasion of blood vessels with thrombosis and tissue infarction - Toxins such as gliotoxin, which depresses immune function - A. flavus makes aflatoxin, linked to liver cancer (via contaminated food) ## Diseases it causes - Aspergillosis: allergic bronchopulmonary (asthma, cystic fibrosis), aspergilloma in old cavities and invasive aspergillosis in the immunosuppressed [Aspergillosis →](https://durgical.com/en/conditions/aspergillosis/) ## Clinical picture - Allergic bronchopulmonary aspergillosis: hard-to-control asthma, eosinophilia, high IgE and central bronchiectasis - Aspergilloma: a fungus ball in an old cavity (for example, from tuberculosis); hemoptysis - Invasive: fever unresponsive to antibiotics, pleuritic pain and nodules with a halo on CT in neutropenia or transplant - Allergic or invasive sinusitis ## Diagnosis - Galactomannan in serum or bronchoalveolar lavage - Beta-D-glucan (supportive, non-specific) - Chest CT: nodules with a halo in invasive disease - Biopsy with septate acute-angle hyphae; culture (grows in a few days); PCR - Susceptibility testing when azole resistance is suspected ## Treatment Invasive disease: broad-spectrum azoles (voriconazole first choice; isavuconazole as an alternative) or lipid amphotericin B. Allergic disease: corticosteroids with or without itraconazole. Aspergilloma: surgery in selected cases. Azole resistance in A. fumigatus is emerging, linked to agricultural fungicide use. Drug class only; doses and regimens are set by the clinician from the current guideline. In Pharmacology: - [Voriconazole](https://durgical.com/en/pharmacology/voriconazole/) - [Isavuconazole](https://durgical.com/en/pharmacology/isavuconazole/) - [Amphotericin B](https://durgical.com/en/pharmacology/amphotericin-b/) - [Itraconazole](https://durgical.com/en/pharmacology/itraconazole/) ## Prevention - Protected environment with HEPA filtration for patients with profound neutropenia or transplant - Dust control during hospital building works - Azole prophylaxis (for example, posaconazole) in high-risk patients ## Memory aid Acute Aspergillus: it branches at acute angles and strikes acutely in the patient with no neutrophils. ## Test yourself Think of the answer, then tap the question to see it. ## What do Aspergillus hyphae look like on biopsy? Thin, septate and branching at acute angles. ## Which fungal antigen is measured in serum or lavage to support invasive aspergillosis? Galactomannan. ## Which form of aspergillosis grows in an old tuberculosis cavity and presents with hemoptysis? Aspergilloma, the fungus ball. ## What is the antifungal of choice for invasive aspergillosis? Voriconazole (a triazole); isavuconazole and lipid amphotericin B are alternatives. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/microbiology/aspergillus-fumigatus/) ## Related - [Mucorales (Rhizopus, Mucor)](https://durgical.com/en/microbiology/mucorales/) - [Candida albicans](https://durgical.com/en/microbiology/candida-albicans/) ## Related conditions - [Aspergillosis](https://durgical.com/en/conditions/aspergillosis/) ## What the colours mean **Gram-positive** Thick peptidoglycan wall: stains purple. **Gram-negative** Thin wall with an outer membrane: stains pink. **Acid-fast** Lipid-rich wall (mycobacteria): Ziehl–Neelsen stain. [← Back to the group: Molds and dermatophytes](https://durgical.com/en/microbiology/groups/molds-and-dermatophytes/) Educational content on microorganisms; not a treatment guide and no substitute for a health professional's advice. No doses are given. Sources: [Aspergillosis Basics](https://www.cdc.gov/aspergillosis/about/index.html) (CDC, 2024); [Clinical Overview of Aspergillosis](https://www.cdc.gov/aspergillosis/hcp/clinical-overview/index.html) (CDC, 2024); [WHO releases first-ever list of health-threatening fungi](https://www.who.int/news/item/25-10-2022-who-releases-first-ever-list-of-health-threatening-fungi) (WHO, 2022). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/microbiology/aspergillus-fumigatus/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/microbiology/aspergillus-fumigatus/