Diagnosing aspergillosis

If it's possible that you have aspergillosis, a number of checks and tests can be carried out to confirm the diagnosis and identify the specific type.

Symptoms and medical history

It's important to describe exactly what symptoms you have, as the symptoms of aspergillosis can vary slightly between the different types.

For example, wheezing is more likely to be a symptom ofallergic bronchopulmonary aspergillosis (ABPA)or severe asthma with fungal sensitisation (SAFS), whilea long-term cough and Weight loss (unexpected and unplanned) are more likely to be caused by chronic pulmonary aspergillosis (CPA).

Your medical history will also be takeninto account, as the different types of aspergillosis are associated with different underlying health problems.

ABPA and SAFS are closely associated with asthma or cystic fibrosis , whereas invasive pulmonary aspergillosis (IPA) occurs more often in people with weakened immune systems.

Allergy tests

If ABPA or SAFS is suspected, you'll usually havea skin prick test .

Your skin will be pricked with a needle that contains a small amount of aspergillus mould. If you're allergic, the area of skin where the needle was insertedwill come up in a hard red bump.

Alternatively, your blood may be tested for aspergillus antibodies called IgE antibodies. These are produced by your immune system if you're allergic to the aspergillus mould.

Blood and mucus tests

If your symptoms are not thought to be caused by an allergy, you may have a blood test to check for different aspergillus antibodies calledIgG antibodies.

These indicate that you've been infected with the aspergillus mould, such as in cases of CPA.

A sample of your mucus can also be tested to see if it contains the mould.

X-rays and scans

A chest X-ray can help determine if you have CPA, as it can show whether there are any clear spaces (cavities) or fungal balls (aspergillomas) in your lungs.

A computerised tomography (CT) scan is useful in helping to diagnose ABPA or SAFS, as it's more detailed andcan show less obvious damage or mucus in the lungs.It can also detect damage caused by IPA.

Bronchoscopy and biopsy

In some cases, a procedure calleda bronchoscopy may be carried out to allow your doctor to directly see inside your lungs and airways.

A bronchoscopy involves inserting along, flexible tube with a camera at the end into your lungs,via your nose or mouth.

During a bronchoscopy, a small piece of affected tissue may be removed (known as a biopsy )to test it for aspergillus mould.