Although Aspergillus species are very common in the human environment, only a limited number of taxa (approximately 17) are capable of initiating human disease. The usual reservoir for an Aspergillus infection is not another infected person but, rather, a nonliving site where the fungus is growing saprophytically. Air conditioning vents, attic insulation, cellar walls, stables, and even houseplants in hospitals have been implicated in various disease states. Because Aspergillus conidia are among the most common of airborne molds, the diseases they cause are usually pulmonary. The single species most commonly associated with human disease is Aspergillus fumigatus. In addition, A. flavus, A. nidulans, A. niger, and A. terreus are regularly implicated.
The term aspergillosis has been broadly used to describe any disease caused by an Aspergillus species, excluding mycotoxicoses. Because this term encompasses so many different clinical entities, with different researchers applying different emphases, and because some conditions defy simple categorization, the medical mycology literature can be confusing. The classification of Kwon-Chung and Bennett (5) and Dixon and Walsh (27) recognizes three broad categories of aspergillosis: (1) allergy, (2) saprophytic colonization, and (3) invasive mycosis.
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