• ANAND PEJGUDE Department of Pharmaceutics Arvind Gavali College of Pharmacy Satara Maharashtra India
  • PRAKASH JADHAV Department of Pharmaceutics Arvind Gavali College of Pharmacy Satara Maharashtra India
  • VISHAL YADAV Department of Pharmaceutics Arvind Gavali College of Pharmacy Satara Maharashtra India




Aspergillosis, Diagnosis, Management, Pulmonary, Risk factors


Aspergillosis is a mycotic sickness ordinarily brought about by Aspergillus fumigatus, a saprophytic and universal airborne growth. Obtrusive aspiratory aspergillosis happens essentially in patients with serious immunodeficiency. The meaning of this contamination has decisively expanded with developing quantities of patients with impeded insusceptible state related with the administration of danger, organ transplantation, immune system and fiery circumstances; fundamentally sick patients and those with constant obstructive aspiratory infection seem, by all accounts, to be at an expanded gamble. Persistent pneumonic aspergillosis influences patients without clear resistant split the difference, yet with a fundamental lung condition like COPD or sarcoidosis, earlier or simultaneous TB or non-tuberculous mycobacterial illness. Aspergillus bronchitis might be liable for tenacious respiratory side effects in patients with Aspergillus identified more than once in sputum without proof of parenchymal Aspergillus sickness, particularly in patients with bronchiectasis and cystic fibrosis. Unfavorably susceptible bronchopulmonary aspergillosis influences patients with asthma and cystic fibrosis and is vital to perceive as long-lasting lung or aviation routes harm might accumulate if untreated. Aspergilloma is normally tracked down in patients with recently shaped cavities in the lung, though unfavorably susceptible bronchopulmonary aspergillosis, an extreme touchiness response to Aspergillus antigens, is, for the most part, found in patients with atopy, asthma or cystic fibrosis. This survey gives a report on advancing the study of disease transmission and hazard elements of the significant indications of Aspergillus lung sickness and the clinical appearances that ought to provoke the clinician to think about these circumstances. Current methodologies for the determination and the board of these disorders are examined.


Download data is not yet available.


Garcia Vidal C, Peghin M, Cervera C, Gudiol C, Ruiz Camps I, Moreno A. Causes of death in a contemporary cohort of patients with invasive aspergillosis. Plos One. 2015 Mar 24;10(3):e0120370. doi: 10.1371/journal.pone.0120370, PMID 25803853.

Meersseman W, Vandecasteele SJ, Wilmer A, Verbeken E, Peetermans WE, Van Wijngaerden E. Invasive aspergillosis in critically ill patients without malignancy. Am J Respir Crit Care Med. 2004 Sep 15;170(6):621-5. doi: 10.1164/rccm.200401-093OC, PMID 15229094.

Pan Z, Fu M, Zhang J, Zhou H, Fu Y, Zhou J. Diagnostic accuracy of a novel lateral-flow device in invasive aspergillosis: a meta-analysis. J Med Microbiol. 2015 Jul 1;64(7):702-7. doi: 10.1099/jmm.0.000092, PMID 26002943.

Patterson TF, Thompson III GR, Denning DW, Fishman JA, Hadley S, Herbrecht R. Practice guidelines for the diagnosis and management of aspergillosis: 2016 update by the Infectious Diseases Society of America. Clin Infect Dis. 2016 Aug 15;63(4):e1-e60. doi: 10.1093/cid/ciw326, PMID 27365388.

Mortensen KL, Johansen HK, Fuursted K, Knudsen JD, Gahrn Hansen B, Jensen RH. A prospective survey of Aspergillus spp. in respiratory tract samples: prevalence, clinical impact and antifungal susceptibility. Eur J Clin Microbiol Infect Dis. 2011 Nov;30(11):1355-63. doi: 10.1007/s10096-011-1229-7, PMID 21541671.

Agarwal R. Allergic bronchopulmonary aspergillosis. Chest. 2009 Mar 1;135(3):805-26. doi: 10.1378/chest.08-2586, PMID 19265090.

Moss RB. Pathophysiology and immunology of allergic bronchopulmonary aspergillosis. Med Mycol. 2005 Jan 1;43Suppl 1:S203-6. doi: 10.1080/13693780500052255, PMID 16110813.

Shah A, Panjabi C. Allergic aspergillosis of the respiratory tract. Eur Respir Rev. 2014 Mar 1;23(131):8-29. doi: 10.1183/09059180.00007413, PMID 24591658.

Greenberger PA. When to suspect and work up allergic bronchopulmonary aspergillosis. Ann Allergy Asthma Immunol. 2013 Jul 1;111(1):1-4. doi: 10.1016/j.anai.2013.04.014, PMID 23806451.

Agarwal R, Maskey D, Aggarwal AN, Saikia B, Garg M, Gupta D. Diagnostic performance of various tests and criteria employed in allergic bronchopulmonary aspergillosis: a latent class analysis. PLOS ONE. 2013 Apr 12;8(4):e61105. doi: 10.1371/journal.pone.0061105, PMID 23593402.

Baxter CG, Dunn G, Jones AM, Webb K, Gore R, Richardson MD. Novel immunologic classification of aspergillosis in adult cystic fibrosis. J Allergy Clin Immunol. 2013 Sep 1;132(3):560-566.e10. doi: 10.1016/j.jaci.2013.04.007, PMID 23726262.

Cohen Cymberknoh M, Blau H, Shoseyov D, Mei Zahav M, Efrati O, Armoni S. Intravenous monthly pulse methylprednisolone treatment for ABPA in patients with cystic fibrosis. J Cyst Fibros. 2009 Jul 1;8(4):253-7. doi: 10.1016/j.jcf.2009.04.008, PMID 19447081.

Russo A, Tiseo G, Falcone M, Menichetti F. Pulmonary aspergillosis: an evolving challenge for diagnosis and treatment. Infect Dis Ther. 2020;9(3):511-24. doi: 10.1007/s40121-020-00315-4, PMID 32638227.

Agarwal R, Aggarwal AN, Dhooria S, Singh Sehgal IS, Garg M, Saikia B. A randomised trial of glucocorticoids in acute-stage allergic bronchopulmonary aspergillosis complicating asthma. Eur Respir J. 2016 Feb 1;47(2):490-8. doi: 10.1183/13993003.01475-2015, PMID 26585431.

Nepomuceno IB, Esrig S, Moss RB. Allergic bronchopulmonary aspergillosis in cystic fibrosis: role of atopy and response to itraconazole. Chest. 1999 Feb 1;115(2):364-70. doi: 10.1378/chest.115.2.364, PMID 10027433.

Stevens DA, Schwartz HJ, Lee JY, Moskovitz BL, Jerome DC, Catanzaro A. A randomized trial of itraconazole in allergic bronchopulmonary aspergillosis. N Engl J Med. 2000 Mar 16;342(11):756-62. doi: 10.1056/NEJM200003163421102, PMID 10717010.

Agarwal R, Dhooria S, Singh Sehgal IS, Aggarwal AN, Garg M, Saikia B. A randomized trial of itraconazole vs prednisolone in acute-stage allergic bronchopulmonary aspergillosis complicating asthma. Chest. 2018 Mar 1;153(3):656-64. doi: 10.1016/j.chest.2018.01.005, PMID 29331473.

Agarwal R, Chakrabarti A, Shah A, Gupta D, Meis JF, Guleria R. Allergic bronchopulmonary aspergillosis: a review of literature and proposal of new diagnostic and classification criteria. Clin Exp Allergy. 2013 Aug;43(8):850-73. doi: 10.1111/cea.12141, PMID 23889240.

Vlahakis NE, Aksamit TR. Diagnosis and treatment of allergic bronchopulmonary aspergillosis. In Mayo Clinic Proceedings 2001 Sep 1.

Knutsen AP, Slavin RG. Allergic bronchopulmonary aspergillosis in asthma and cystic fibrosis. Clin Dev Immunol. 2011 Oct;2011:843763. doi: 10.1155/2011/843763, PMID 21603163.

Schweer KE, Bangard C, Hekmat K, Cornely OA. Chronic pulmonary aspergillosis. Mycoses. 2014 May;57(5):257-70. doi: 10.1111/myc.12152, PMID 24299422.

Denning DW, Cadranel J, Beigelman Aubry C, Ader F, Chakrabarti A, Blot S. Chronic pulmonary aspergillosis: rationale and clinical guidelines for diagnosis and management. Eur Respir J. 2016 Jan 1;47(1):45-68. doi: 10.1183/13993003.00583-2015, PMID 26699723.

Soubani AO, Chandrasekar PH. The clinical spectrum of pulmonary aspergillosis. Chest. 2002 Jun 1;121(6):1988-99. doi: 10.1378/chest.121.6.1988, PMID 12065367.

Hizel K, Kokturk N, Kalkanci A, Ozturk C, Kustimur S, Tufan M. Polymerase chain reaction in the diagnosis of invasive aspergillosis. Mycoses. 2004 Aug;47(7):338-42. doi: 10.1111/j.1439-0507.2004.00944.x, PMID 15310341.

Smith NL, Denning DW. Underlying conditions in chronic pulmonary aspergillosis including simple aspergilloma. Eur Respir J. 2011 Apr 1;37(4):865-72. doi: 10.1183/09031936.00054810, PMID 20595150.

Jhun BW, Jeon K, Eom JS, Lee JH, Suh GY, Kwon OJ. Clinical characteristics and treatment outcomes of chronic pulmonary aspergillosis. Med Mycol. 2013 Nov 1;51(8):811-7. doi: 10.3109/13693786.2013.806826, PMID 23834282.

Denning DW, Riniotis K, Dobrashian R, Sambatakou H. Chronic cavitary and fibrosing pulmonary and pleural aspergillosis: case series, proposed nomenclature change, and review. Clin Infect Dis. 2003 Oct 1;37Suppl 3:S265-80. doi: 10.1086/376526, PMID 12975754.

Ohba H, Miwa S, Shirai M, Kanai M, Eifuku T, Suda T. Clinical characteristics and prognosis of chronic pulmonary aspergillosis. Respir Med. 2012 May 1;106(5):724-9. doi: 10.1016/j.rmed.2012.01.014, PMID 22349065.

Lai G, Zeng C, Mo J, Song WD, Xu P. Diagnostic value of galactomannan in bronchoalveolar lavage fluid for chronic respiratory disease with pulmonary aspergillosis. J Clin Microbiol. 2020 Feb 24;58(3):e01308-19. doi: 10.1128/JCM.01308-19, PMID 31941687.

Shin B, Koh WJ, Jeong BH, Yoo H, Park HY, Suh GY. Serum galactomannan antigen test for the diagnosis of chronic pulmonary aspergillosis. J Infect. 2014 May 1;68(5):494-9. doi: 10.1016/j.jinf.2014.01.005, PMID 24462563.

Kanj A, Abdallah N, Soubani AO. The spectrum of pulmonary aspergillosis. Respir Med. 2018 Aug 1;141:121-31. doi: 10.1016/j.rmed.2018.06.029, PMID 30053957.

Moodley L, Pillay J, Dheda K. Aspergilloma and the surgeon. J Thorac Dis. 2014 Mar;6(3):202-9. doi: 10.3978/j.issn.2072-1439.2013.12.40, PMID 24624284.

Kohno S, Izumikawa K. Posaconazole for chronic pulmonary aspergillosis: the next strategy against the threat of azole-resistant Aspergillus infection. Clin Infect Dis. 2010 Dec 15;51(12):1392-4. doi: 10.1086/657307, PMID 21054178.

Felton TW, Baxter C, Moore CB, Roberts SA, Hope WW, Denning DW. Efficacy and safety of posaconazole for chronic pulmonary aspergillosis. Clin Infect Dis. 2010 Dec 15;51(12):1383-91. doi: 10.1086/657306, PMID 21054179.

Maghrabi F, Denning DW. The management of chronic pulmonary aspergillosis: the UK national aspergillosis centre approach. Curr Fungal Infect Rep. 2017 Dec;11(4):242-51. doi: 10.1007/s12281-017-0304-7, PMID 29213345.

Abdul Aziz MH, Alffenaar JC, Bassetti M, Bracht H, Dimopoulos G, Marriott D. Antimicrobial therapeutic drug monitoring in critically ll adult patients: a position paper. Intensive Care Med. 2020 Jun;46(6):1127-53. doi: 10.1007/s00134-020-06050-1, PMID 32383061.

Passera E, Rizzi A, Robustellini M, Rossi G, Della Pona C, Massera F. Pulmonary aspergilloma: clinical aspects and surgical treatment outcome. Thorac Surg Clin. 2012 Aug 1;22(3):345-61. doi: 10.1016/j.thorsurg.2012.04.001, PMID 22789598.

Meersseman W, Lagrou K, Maertens J, Van Wijngaerden EV. Invasive aspergillosis in the intensive care unit. Clin Infect Dis. 2007 Jul 15;45(2):205-16. doi: 10.1086/518852, PMID 17578780.

Wauters J, Baar I, Meersseman P, Meersseman W, Dams K, De Paep R. Invasive pulmonary aspergillosis is a frequent complication of critically ill H1N1 patients: a retrospective study. Intensive Care Med. 2012 Nov;38(11):1761-8. doi: 10.1007/s00134-012-2673-2, PMID 22895826.

Koulenti D, Vogelaers D, Blot S. What’s new in invasive pulmonary aspergillosis in the critically ll. Intensive Care Med. 2014 May;40(5):723-6. doi: 10.1007/s00134-014-3254-3, PMID 24647810.

Baddley JW, Andes DR, Marr KA, Kontoyiannis DP, Alexander BD, Kauffman CA. Factors associated with mortality in transplant patients with invasive aspergillosis. Clin Infect Dis. 2010 Jun 15;50(12):1559-67. doi: 10.1086/652768, PMID 20450350.

Russo A, Giuliano S, Vena A, Lucidi C, Falcone M, Raponi G. Predictors of mortality in non-neutropenic patients with invasive pulmonary aspergillosis: does galactomannan have a role? Diagn Microbiol Infect Dis. 2014 Sep 1;80(1):83-6. doi: 10.1016/j.diagmicrobio.2014.05.015, PMID 24962954.

Russo A, Falcone M, Vena A, Venditti C, Mancini C, Morelli A. Invasive pulmonary aspergillosis in non-neutropenic patients: analysis of a 14 mo prospective clinical experience. J Chemother. 2011 Oct 1;23(5):290-4. doi: 10.1179/joc.2011.23.5.290, PMID 22005062.

Usmonov UD, Nishonov FN, Otakuziev AZ, Stepanova YA, Vishnevsky VA, Botiraliev AS. Concomitant liver disease: echinococcosis and aspergillosis. J Exp Clin Surg. 2021 Mar 26;14(1):10-8. doi: 10.18499/2070-478X-2021-14-1-10-18.

Koehler P, Cornely OA, Böttiger BW, Dusse F, Eichenauer DA, Fuchs F. COVID‐19 associated pulmonary aspergillosis. Mycoses. 2020 Jun;63(6):528-34. doi: 10.1111/myc.13096, PMID 32339350.

Segal BH, Romani LR. Invasive aspergillosis in chronic granulomatous disease. Med Mycol. 2009;47Suppl 1:S282-90. doi: 10.1080/13693780902736620. PMID 19296367.

Ullmann AJ, Aguado JM, Arikan Akdagli S, Denning DW, Groll AH, Lagrou K. Diagnosis and management of Aspergillus diseases: executive summary of the 2017 ESCMID-ECMM-ERS guideline. Clin Microbiol Infect. 2018 May 1;24Suppl 1:e1-e38. doi: 10.1016/j.cmi.2018.01.002, PMID 29544767.

Donnelly JP, Chen SC, Kauffman CA, Steinbach WJ, Baddley JW, Verweij PE. Revision and update of the consensus definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer and the Mycoses Study Group Education and Research Consortium. Clin Infect Dis. 2020;71(6):1367-76. doi: 10.1093/cid/ciz1008, PMID 31802125.

Blot SI, Taccone FS, Van den Abeele AM, Bulpa P, Meersseman W, Brusselaers N. A clinical algorithm to diagnose invasive pulmonary aspergillosis in critically ill patients. Am J Respir Crit Care Med. 2012 Jul 1;186(1):56-64. doi: 10.1164/rccm.201111-1978OC, PMID 22517788.

Bassetti M, Peghin M, Vena A. Challenges and solution of invasive aspergillosis in non-neutropenic patients: a review. Infect Dis Ther. 2018 Mar;7(1):17-27. doi: 10.1007/s40121-017-0183-9, PMID 29273978.

Bassetti M, Bouza E. Invasive mould infections in the ICU setting: complexities and solutions. J Antimicrob Chemother. 2017 Mar 1;72(Suppl 1):i39-47. doi: 10.1093/jac/dkx032, PMID 28355466.

Malhotra S, Kumari R, Chauhan AK, Bhatia NK, Kaur A, Sharma B. Diagnostic value of galactomannan antigen test in serum and bronchoalveolar lavage fluid sample from suspected patients of invasive pulmonary aspergillosis. Indian J Pathol Microbiol. 2021 Oct 1;64(4):732-4. doi: 10.4103/IJPM.IJPM_985_20, PMID 34673593.

Guinea J, Bouza E. Current challenges in the microbiological diagnosis of invasive aspergillosis. Mycopathologia. 2014 Dec;178(5-6):403-16. doi: 10.1007/s11046-014-9763-3, PMID 24947167.

Kovanda LL, Kolamunnage Dona R, Neely M, Maertens J, Lee M, Hope WW. Pharmacodynamics of isavuconazole for invasive mold disease: role of galactomannan for real-time monitoring of therapeutic response. Clin Infect Dis. 2017 Jun 1;64(11):1557-63. doi: 10.1093/cid/cix198, PMID 28472247.

Chai LY, Kullberg BJ, Johnson EM, Teerenstra S, Khin LW, Vonk AG. Early serum galactomannan trend as a predictor of the outcome of invasive aspergillosis. J Clin Microbiol. 2012 Jul;50(7):2330-6. doi: 10.1128/JCM.06513-11, PMID 22553232.

Kanafani ZA. [Beta-D-glucan assay for the diagnosis of invasive fungal infections: a meta-analysis]-D-glucan assay for the diagnosis of invasive fungal infections: a meta-analysis. The Journal of Invasive Fungal Infections. 2011 Jul 1;5(3):93.

Lamoth F, Cruciani M, Mengoli C, Castagnola E, Lortholary O, Richardson M, Marchetti O. β-Gglucan antigenemia assay for the diagnosis of invasive fungal infections in patients with hematological malignancies: a systematic review and meta-analysis of cohort studies from the Tthird European Conference on Infections in Lleukemia (ECIL-3). Clinical Infectious Diseases. 2012;54(5):633-43. doi: 10.1093/cid/cir897, PMID 22198786.

Onishi A, Sugiyama D, Kogata Y, Saegusa J, Sugimoto T, Kawano S, Morinobu A, Nishimura K, Kumagai S. Diagnostic accuracy of serum 1, 3-β-D-glucan for Pneumocystis jiroveci pneumonia, invasive candidiasis, and invasive aspergillosis: systematic review and meta-analysis. Journal of Clinical Microbiology. 2012 Jan;50(1):7-15. doi: 10.1128/JCM.05267-11, PMID 22075593.

Giacobbe DR, Cortegiani A, Karaiskos I, Mercier T, Tejada S, Peghin M, Asperges E, Zuccaro V, Scudeller L. Performance of existing definitions and tests for the diagnosis of invasive fungal diseases other than invasive candidiasis and invasive aspergillosis in critically ll, Adult patients: a systematic review with qualitative evidence synthesis. Journal of Fungi. 2021;7(3):176.

Theel ES, Jespersen DJ, Iqbal S, Bestrom JE, Rollins LO, Misner LJ, Markley BJ, Mandrekar J, Baddour LM, Limper AH, Wengenack NL. Detection of (1, 3)-β-D-glucan in bronchoalveolar lavage and serum samples collected from immunocompromised hosts. Mycopathologia. 2013 Feb;175(1-2):33-41. doi: 10.1007/s11046-012-9579-y, PMID 22945270.



How to Cite

PEJGUDE, A., P. JADHAV, and V. YADAV. “PULMONARY ASPERGILLOSIS: A CLINICAL NOTE”. International Journal of Current Pharmaceutical Research, vol. 14, no. 4, July 2022, pp. 16-22, doi:10.22159/ijcpr.2022v14i4.2008.



Review Article(s)