Pulmonary aspergillosis in phthisiatric practice: problem status, differential diagnosis, clinical observations

The article presents literature data on the pathogenesis, classification, clinic and diagnosis of aspergillosis, own clinical observations demonstrating the development of aspergillosis depending on the premorbid background of patientsare presented.In HIV-negative patients, aspergillosis differs from tuberculosis in the absence of MBT in sputum despite presence of cavities and a characteristic pattern on CT scans with dense masses inside the cavity. In HIV-infected individuals, the differential diagnosis of aspergillosis is difficult due to its acute course, development of pulmonary dissemination, and the absence of fungal masses inside the cavities. The development of mycosis at CD4 count less than 100 cells/µl, the absence of MBT in sputum despite presence of cavities, pronounced interstitial changes in lung tissue detected with CT are considered as important diagnostic points.