Aspergillosis: Epidemiology, Diagnosis, and Treatment

Infect Dis Clin North Am. 2021 Jun;35(2):415-434. doi: 10.1016/j.idc.2021.03.008.

Abstract

The spectrum of disease produced by Aspergillus species ranges from allergic syndromes to chronic pulmonary conditions and invasive infections. Invasive aspergillosis is a major cause of morbidity and mortality in immunocompromised patients. Risk factors continue to evolve and include newer biological agents that target the immune system and postinfluenza infection; and it has been observed following COVID-19 infection. Diagnosis remains a challenge but non-culture-based methods are available. Antifungal resistance has emerged. Voriconazole remains the treatment of choice but isavuconazole and posaconazole have similar efficacy with less toxicity. Combination therapy is used with extensive infection and in severe immunosuppression.

Keywords: Aspergilloma; Aspergillosis; Chronic cavitary aspergillosis; Invasive pulmonary aspergillosis; Resistance.

Publication types

  • Review

MeSH terms

  • Antifungal Agents / therapeutic use*
  • Aspergillosis* / complications
  • Aspergillosis* / diagnosis
  • Aspergillosis* / drug therapy
  • Aspergillosis* / epidemiology
  • Aspergillus / classification
  • Aspergillus / isolation & purification
  • COVID-19 / complications
  • Disease Susceptibility
  • Drug Resistance, Fungal
  • Humans
  • Immunocompromised Host
  • Invasive Pulmonary Aspergillosis / diagnosis
  • Invasive Pulmonary Aspergillosis / drug therapy
  • Invasive Pulmonary Aspergillosis / epidemiology
  • Risk Factors

Substances

  • Antifungal Agents