Aspergillosis of bone

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Abstract
Although usually a harmless inhabitant of the upper respiratory tract, Aspergillus species may at times be associated with human disease. Aspergillus fumigatus is by far the most common pathogen, but other species (A. niger, A. flavus and A. nidulans) have also been implicated. Aspergillus is most commonly found in a fungus ball within a pre-existing cavitary lung lesion; it may also be seen in hypersensitivity reactions associated with mucoid impaction. Primary infection with Aspergillus is rare, and presents as a chronic localized pulmonary infection, usually with cavitation (Felson, 1973; Fraser and Pare, 1970). Occasionally, and particularly in patients with disordered immune response, Aspergillus may become invasive. The increasing use of immunosuppressive therapy has seen a corresponding increase in the incidence of “opportunistic” aspergillosis. This virtually always presents as lung disease, most often as single or multiple areas of consolidation with cavitation. Dissemination from the initial pulmonary disease may occur, and involvement of nearly every organ in the body has been reported. Young and co-workers (1970) in describing their experiences with 98 cases of aspergillosis recorded involvement of the brain, liver, kidney, heart, thyroid skin, and testis. In none of their cases, however, was bone involved.

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