Aspergillus: A Hidden Threat in Vulvovaginal Health

Aspergillus is a fungus that can cause vulvovaginal infections. Spores are often present in the air, but Aspergillus doesn’t typically cause infections without a compromised immune system. This doesn’t always apply to vulvovaginal infections.

The most common entry point for Aspergillus is the nose and lungs, but the fungus may enter your system via air, food, or direct contact. Dirty air conditioning units, compost, and damp or flood-damaged homes may produce a high level of Aspergillus spores.¹

Egyptian pharaoh tomb robber’s curse of the vagina

It’s believed that a thousand-year-old Aspergillus niger survived in the decomposing flesh and the fabric wraps of ancient Egyptian pharaoh mummies.

When the caskets were opened, the fungi may have become airborne and breathed in by the excavator (robber) of the tomb, which would, within a few weeks, turn into a deadly case of mysterious pneumonia and kill the robber.

Aspergillus in the vagina²

In the vagina, Aspergillus is not a common fungus related to chronic recurrent vaginal infections, with just one publication linking Aspergillus with vaginal infections.

Chronic, unresponsive infections of the vulva, vestibule and/or vagina – in women without compromised immune systems, it’s important to note – were identified. These infections were treated with itraconazole for 30 days, and this treatment effectively resolved the infection in that group of patients.³

In one Egyptian study, those who had intrauterine devices (IUDs) and douched were most at risk of infections, with about half the women with vulvovaginal infections, 7.4 per cent were found to have Aspergillus present.

The researchers (Baggish and Ventolini) concluded that Aspergillus would, if given the opportunity, cause serious infection. The researchers recommended that Aspergillus be added to the list of suspect microbes in those who present with chronic vulvovaginal fungal infections.

Symptoms of Aspergillus infection in the vagina

Any effect from Aspergillus may be referred to as aspergillosis. That is, an allergy to, an infection from, or fungal overgrowth of Aspergillus. Overgrowth can cause symptoms similar to a regular yeast infection, such as itching, soreness, rawness and discharge.

Treating vulvovaginal Aspergillus infection

Biomedical treatment is antifungal, Itraconazole, 200 mg daily for 30 days. Garlic is known to inhibit Aspergillus and can be used vaginally.^4,5

About Aspergillus

The genus Aspergillus is comprised of hundreds of moulds, with each species found in different corners of the globe. This fungus can produce deadly disease in humans, due to the range of toxins the fungi produce.

One of the most potent is a powerful carcinogen, aflatoxin. Aspergillus prefer areas where there is decomposition, waste, or anything that remains still. Aspergillus colonises and infects areas of the human body that have varying pH.^1,6

References

1.
Mousavi B, Hedayati MT, Hedayati N, et al. Aspergillus species in indoor environments and their possible occupational and public health hazards. mazu-cmm. Published online March 1, 2016:36-42. doi:10.18869/acadpub.cmm.2.1.36
2.
Chandra S, Gaur D, Harsh M, Chaturvedi J, Kishore S. An Unusual Presentation of Aspergillus Species in a Routine Cervicovaginal Pap Smear. Acta Cytologica. Published online 2009:229-231. doi:10.1159/000325131
3.
Baggish MS, Ventolini G. Vulvovaginal Colonization by Aspergillus Species in Nonimmunocompromised Women. Journal of Gynecologic Surgery. Published online June 2008:55-60. doi:10.1089/gyn.2008.b-00242-1
4.
Pai ST, Platt MW. Antifungal effects of Allium sativum (garlic) extract against the Aspergillus species involved in otomycosis. Lett Appl Microbiol. Published online January 1995:14-18. doi:10.1111/j.1472-765x.1995.tb00397.x
5.
Ismaiel A, Rabie G, Kenawey S, Abd EA. Efficacy of aqueous garlic extract on growth, aflatoxin B1 production, and cyto-morphological aberrations of Aspergillus flavus, causing human ophthalmic infection: topical treatment of A. flavus keratitis. Braz J Microbiol. 2012;43(4):1355-1364. doi:10.1590/S1517-838220120004000017
6.
Rhodes J, Abdolrasouli A, Dunne K, et al. Population genomics confirms acquisition of drug-resistant Aspergillus fumigatus infection by humans from the environment. Nat Microbiol. Published online April 25, 2022:663-674. doi:10.1038/s41564-022-01091-2