Invasive Aspergillosis

In Brief Invasive aspergillosis (IA) typically develops in patients with compromised immune status and/or severe neutropenia. The clinical manifestations are not specific, but there are suggestive radiographic appearances. A high index of suspicion for IA in an immunocompromised host with persistent fever should prompt early initiation of empiric treatment combined with a confirmatory diagnostic approach. Despite recent advancements in diagnosis and treatment options, the development of IA continues to be associated with a high mortality rate. Prompt recognition, the institution of effective antifungal therapy, and if necessary, surgical resection can significantly improve the chance for survival. Correction of the underlying host immune deficiency and/or neutropenia is associated with a greater likelihood for improved outcome. This paper presents a typical case of IA, along with a review of the epidemiology, pathogenesis, clinical presentation, diagnostic approach, and treatment of this highly lethal disease. This article includes a case report and review of the diagnosis and treatment of aspergillosis. Included in the discussion are various diagnostic techniques with variable strengths and limitations. In addition, with a variety of antifungal treatments available to clinicians, we provide guidance on selection of antifungal treatments.