Great Balls of Fungus

Following his correct replies to my literary trivia and the receipt of his Kudos, Extreme Unction requested the name of a respiratory infection that could be obtained from living in a damp Irish boarding house. As per that request:

Aspergillus fumigatus is one of the most common spores you might encounter in the environment, and the one most likely to lead to a respiratory infection. Typically it affects individuals with certain predisposing factors, such as immunosuppression, asthma, cystic fibrosis, or previous cavitary lung disease (i.e. TB). The manifestations of the disease differ depending upon the host's status. For instance, if your boarding house resident has asthma, he might become infected with Allergic Bronchopulmonary Aspergillosis (ABPA), involving high fever, cough, hemoptysis (bloody sputum), and general respiratory distress (wheezing, difficulty maintaining oxygen saturation of the blood, etc.). If, on the other hand, your character has a hole in his lung such as from a previous TB infection, he might form an aspergilloma, which is literally a ball of fungus that occupies that lung cavity; the manifestations of this sort of infection would not be as severe as ABPA because the fungus ball remains somewhat isolated in the lung tissue, but symptoms would nonetheless include fever, cough, and bloody sputum -- the latter of which can, in some cases, become massive and life threatening. Finally, if your boarding house resident has some degree of generalized immunosuppression, such as AIDS, neutropenia (reduced white blood cell counts due perhaps to cancer or its treatment), immunosuppressive therapy, or even severe alcoholism, he might suffer from either invasive aspergillosis or chronic necrotizing aspergillosis. The former is a uniformly life-threatening infection involving, as the name implies, an invasion of multiple body tissues after the aspergillus spores make their way into the bloodstream and disseminate broadly. The latter, chronic necrotizing aspergillosis, is a longer-term, less acute infection of the lungs that may mimic various other types of pneumonia and lead to multiple rounds of futile antibiotic treatment. It ultimately can lead to the death (necrosis) of large areas of lung tissue if allowed to progress unchecked.

Anyhow, this may have been more info than you desired, but I wanted to provide a thorough list of clinical scenarios in order to provide the best fodder for your story. It strikes me the aspergilloma is the most fascinating infection, as the fungus sets up shop in its own sequestered micro-environment of the lung, and can remain there for years. A character with this problem might even find himself coughing up the same stuff that's growing on the walls of the damp boarding house room. All he needs in order to be eligible for this fascinating disease is a hole in the lung; if TB isn't glamorous enough, perhaps he could have suffered a gunshot wound to the chest at some point; all of those fungi could crowd themselves around a nice .22 caliber bullet lodged in his right upper lobe. In any case, good luck with the writing.