National Aspergillosis Centre
Wythenshawe, Manchester
What is aspergillosis?
Aspergillus mould causes a wide range of infections and allergies. Superficial nail or ear infections may be treated by GPs, while consultants are needed to treat invasive or deep tissue infections (e.g. lungs, CNS, endocarditis). Chronic infections and allergic forms of aspergillosis are less common and complex cases may require referral to a specialist clinic such as the National Aspergillosis Centre in Manchester
Aspergillus spores (conidia) are ubiquitous in the environment, particularly in rotting vegetation, but do not cause disease in most healthy people. Spores enter the lungs continuously but are normally cleared by alveolar macrophages, neutrophils or lung epithelium. Asymptomatic colonisation is common in people with impaired mucociliary clearance (e.g. CF or bronchiectasis).
Aspergillosis case reports
These cases are ‘typical’ examples of three types of aspergillosis that a UK clinician may come across during their career, but
For a more in depth discussion of the spectrum of disease please see Kosmidis & Denning (2015)
- 62F with COPD
- Worsening cough, slight haemoptysis
- Could this be CPA?
- 78M with asthma
- Mucus plugs, sticky sputum
- Could it be ABPA?
- 45M with diabetes
- In ICU with COVID
- Worsening fever despite antibiotics
- Could this be CAPA?
About the National Aspergillosis Centre (Manchester)
The National Aspergillosis Centre is an NHS highly specialised service based at Wythenshawe Hospital (Manchester University NHS Foundation Trust)
We were commissioned to treat patients with chronic pulmonary aspergillosis from across the UK
We work closely with the Mycology Reference Centre Manchester, who offer specialist fungal diagnostics such as Aspergillus PCR, high-volume culture and pyrosequencing
Our team includes specialist nurses, pharmacists and physiotherapists to manage all aspects of patient care, which is especially important for patients on long-term antifungals
Patient support
NAC is also very active in providing support for our patients and their carers. Chronic aspergillosis is a rare disease and many patients feel isolated, with no-one around them who understands. This is especially true at the time of initial diagnosis or when treatment is stopped due to antifungal resistance.
Our support groups are open to any UK patients with a diagnosis of aspergillosis. If you have a patient you feel would benefit, then either contact us to receive a Zoom invite or direct them to join our Facebook group.
Personal stories
We hold weekly patient support meetings on Zoom, where patients can share experiences and support each other in a private virtual environment.
We also help patients record their stories and share them to promote awareness of this rare disease.
Practical support & information
We produce many practical guides to living with aspergillosis, which are found on our Patients & Carers website
We hold a monthly Zoom meeting with updates on the latest scientific research and practical advice. Patients can request talks on specific topics (e.g. nutrition, mental health) and ask questions on all aspects of their care
Awareness
One of the main challenges facing patients with aspergillosis is the lack of understanding among medical professionals and the public. We promote awareness at conferences and are members of groups such as CPAnet and the ERS patient advocacy network
We hold #WorldAspergillosisDay on 1st Feb each year
Many of our patient and awareness activities are supported by the Fungal Infection Trust (a registered charity)
More learning resources
Listen to an interview with Dr Chris Kosmidis (National Aspergillosis Centre) discussing what a respiratory generalist needs to know about ABPA (part 1) or CPA and IA (part 2).
Earn CPD points by completing this MIMS course written by doctors at NAC. Covering pathophysiology, diagnoses and antifungal treatment
Find out about the latest medical mycology research with the MRC CMM seminar series. Join live on Zoom or catch up any time on their YouTube channel