Invasive Aspergillosis
Invasive aspergillosis is tissue-invasive infection by Aspergillus mould, usually beginning in the lungs during profound immune suppression.
Key takeaways
- Prolonged neutropenia, stem-cell or organ transplant and high-dose corticosteroids are major risk settings.
- Fever despite broad antibiotics, pleuritic chest pain, cough or coughing blood should prompt urgent CT and fungal evaluation.
- Antifungal choice depends on disease site, interactions, organ function and local resistance, with therapeutic monitoring often needed.
The listings below are not for empirical outpatient use; suspected invasive aspergillosis requires urgent specialist and hospital care.
Establishing invasive disease
Chest CT may show nodules, halo changes or cavitation. Galactomannan, PCR, culture and bronchoscopy contribute evidence, but no single result is definitive in every host. Brain or other-organ imaging is added when symptoms suggest dissemination.
Treatment priorities
Voriconazole or isavuconazole are common first-line options in appropriate patients, while liposomal amphotericin has important roles. Azoles interact with many transplant, oncology and cardiovascular medicines and can affect liver or heart rhythm. Reducing immune suppression or restoring neutrophils is considered when feasible.
When to seek urgent care
Seek emergency care for coughing blood, severe or worsening breathlessness, chest pain, confusion, seizure, new weakness or persistent fever during major immune suppression.