Revealed: The hidden fungus on YOUR pillows that can trigger an incurable lung infection

LAID low with a fever, chills, dizziness and muffled hearing, 36-year-old Stewart Armstrong assumed he was suffering from a bad bout of flu.

Two weeks later, with no sign of improvement — and under pressure from his partner, Janine — the businessman went to see his GP. The doctor could find nothing obviously wrong and prescribed pills to combat the dizziness.

Blood test results also offered no answers. But the day after seeing his GP, Stewart started coughing up clots of blood.

In fact, Stewart had aspergillosis, a fungal infection in his lung, although it would take many months before he would finally get the treatment he needed.

Aspergillosis is the umbrella name for conditions caused by the common mould aspergillus fumigatus.

The mould gives off microscopic particles — spores — that are extremely light and float easily in the air. This is how the mould proliferates (when the spores germinate, they develop into full-grown green and white fungus) and, if inhaled, can cause infection.

Aspergillus spores are found all around us, indoors and outside. The mould is common in rotting leaves and compost, as well as in air-conditioning units and heating systems, and in insulation material in walls and lofts.

Like other moulds, it thrives in warm, damp environments. For this reason it can be found in bathrooms and kitchens (although it’s not what causes the black spots of mould often visible in these rooms).

A small 2005 study by the University of Manchester, published in the journal Allergy, suggested that most normal household pillows will have aspergillus growing in them — possibly because it feeds off dust mite faeces.

The mould most commonly causes allergic reactions, triggering symptoms such as wheezing and coughing. This is a particular problem in people with asthma, exacerbating symptoms in one in 40 people. But it can also cause a long-term, incurable infection in the lungs known as chronic pulmonary aspergillosis, which not only causes symptoms such as a severe cough and shortness of breath, but also fatigue and weight-loss.

If left untreated, it can cause serious and potentially fatal damage to the lungs — as Stewart would discover.

Stewart believes he may have been exposed to an especially heavy concentration of aspergillus when he pulled down a ceiling during home refurbishments several years ago — though specialists say it is impossible to say for sure.

Spores: The mould gives off microscopic particles that are extremely light and, if inhaled, can cause infection

Most people’s immune systems will be able to destroy the spores they inhale, but those with existing lung problems — such as chronic obstructive pulmonary disease (COPD) and asthma — or who have had previous lung surgery or a collapsed lung, are more vulnerable.

Several years before, Stewart had been diagnosed with sarcoidosis — an auto-immune disease that causes patches of raw and inflamed tissue, usually on the lungs and skin — and this put him at risk.

The problem is, aspergillosis infection is not necessarily on the radar of many health professionals so may not be spotted. Officially, chronic pulmonary aspergillosis affects up to just 700 people a year, though some experts believe the actual number affected is ten times higher.

After Stewart started coughing up blood, he called his sister, Claire, a nurse, and on her advice took himself off to A&E near his home in Ramsgate, Kent.

The hospital referred him to the specialist he’d seen for his sarcoidosis, who in turn referred him for a CT scan at the Royal Brompton Hospital in London.

While he waited for the results —which would take several weeks — Stewart became steadily more poorly, with ongoing flu-like symptoms, weight loss and a severe cough. He was housebound and unable to work.

The scan results revealed a fungal ball about the size of a 10p in his left lung — which Stewart now knows was an aspergilloma, a ball of aspergillus fungus, though he says no one mentioned aspergillosis at this stage, only that it could be some kind of fungal infection.

He was prescribed anti-fungal itraconazole tablets (sometimes used to treat thrush) and returned home. But he then suffered an allergic reaction to the drug, had a seizure and was taken to hospital in an ambulance.

He was advised to come off the itraconazole, which he did.

Unpleasant! A 2005 study by the University of Manchester suggested that most normal household pillows will have aspergillus growing in them — possibly because it feeds off dust mite faeces

Anxious for an alternative — and, he says, not offered one by his new specialist in London — he did his own research online and came across the National Aspergillosis Centre (NAC), the only one of its kind in the world, attached to the University Hospital of South Manchester.

Two weeks later, Stewart saw a consultant at the centre and was diagnosed with chronic pulmonary aspergillosis. As well as the fungal ball in one lung, there was aspergillus fungus living in cavities (holes) in his lungs, which his doctors believe were, in all likelihood, previous injuries caused by his sarcoidosis.

An aspergillosis infection in the lungs can only be managed, not cured, usually with long-term antifungal medication, and a growing fungal ball can cause inflammation and tissue damage, which requires surgery either to remove the ball itself or to remove lung tissue.

Stewart’s infection was eating into his lungs and stimulating new blood vessels to form, which was causing the lungs to bleed. But there was more bad news. The consultant said that if treatment with alternative anti-fungal medication didn’t work, Stewart ‘could have 12 to 18 months to live’.

‘I had a seven-hour train ride home to digest the news,’ says Stewart. ‘I just couldn’t believe it. I was 35 and they were telling me I’m going to be killed by an incurable fungus, a condition you never hear about anywhere. I just felt extremely isolated.’

Unfortunately, Stewart suffered a severe allergic reaction to his new medication, so he came off it and returned to the NAC a couple of months later to meet Professor David Denning, a world expert on fungal diseases and the driving force behind the centre’s establishment.

Professor Denning prescribed a dual approach.

To stop the bleeding, Stewart would need an embolisation, where small plastic beads are injected into the new blood vessels, blocking them. The procedure would deprive the fungus of a food supply, as it feeds off the blood leaking from these arteries.

Professor Denning also prescribed posaconazole, a relatively new anti–fungal treatment. It’s expensive — £26,000 a year — and the NAC is the only centre that can prescribe the drug for chronic pulmonary aspergillosis. It works by slowing the growth of fungi.

Stewart began the treatment last June, six months after his first symptoms. Thankfully, he suffered no adverse reaction to the drugs and the embolisation seems to have stopped the bleeding.

Signs: The mould most commonly causes allergic reactions, triggering symptoms such as wheezing

Scans show that the infected areas have shrunk, although the fungal ball remains unchanged, and its size and location means it cannot be removed by surgery.

Stewart will have to stay on the posaconazole or some variant of it for the rest of his life. He says he feels noticeably better, has put on weight and is much less tired.

Yet the impact on his life cannot be underestimated, as he cannot afford to get ill. He has had air filters and dehumidifiers installed in his home to clean the air of fungal spores and remove the moisture that they require to survive.

He no longer travels by plane because of the risk of air contaminants, and he has his house cleaned three times a week.

Exactly why some people are vulnerable to CPA is not clear, but Professor Denning says the current thinking is that it’s down to a combination of an existing lung complaint, genetics and exposure to the aspergillus fungus.

He is concerned that not enough GPs, or even respiratory nurses, are ‘thinking enough about the fungal complications that can arise as a result of chronic respiratory disease or lung injuries’.

There is a blood test, the precipitin blood test, that can detect the presence of aspergillosis antibodies, which is available to all GPs and hospitals.

Chronic condition: An aspergillosis infection in the lungs can only be managed, not cured, usually with long-term antifungal medication

But because it is generally considered a ‘rare’ disease, says Professor Denning, too often such tests are simply not requested. Instead, patients are offered a ‘standard’ blood test to check for things like anaemia or liver or thyroid abnormalities — but this won’t spot aspergillosis.

No one can give Stewart an exact prognosis. For now, he and Janine, 28, are planning their wedding and he is throwing himself into work with his new company, Pure Elite, which runs fitness modelling contests.

But as Janine says: ‘In some ways, a cancer diagnosis would have been easier, as there’d be a clearer outcome one way or the other.

‘With chronic pulmonary aspergillosis, we’re in this limbo waiting for something bad to happen but not knowing if it will or not.’

Credits: DailyMail