Clinical manifestations range from non-invasive allergic broncho-pulmonary aspergillosis, and aspergilloma, to invasive pulmonary aspergillosis, chronic necrotising pulmonary aspergillosis, and occasionally extra pulmonary manifestations involving organs like the liver, kidney, GI tract, eyes, brain and skin. Invasive and extrapulmonary manifestations are particularly seen in immunocompromised hosts such as those with underlying haematological malignancies, transplant recipients, or those receiving long-term immunosuppressive therapies. Pulmonary aspergillosis has been associated with some risk groups of individuals infected with SARS-CoV-2.
Building works in the healthcare setting poses the risk of nosocomial aspergillosis in vulnerable patient populations, especially where appropriate infection prevention and control measures have not been adequately implemented.
Aspergillus infections usually start in the lung following inhalation of environmental Aspergillus spores. Presenting symptoms of invasive pulmonary aspergillosis include fever, chest pain, and haemoptysis.
Galactomannan, a cell wall component of Aspergillus is a key diagnostic marker for the detection of invasive aspergillosis. Evidence of infection is usually supported by clinical history, radiological findings, diagnostic markers including galactomannan and serum β-d glucan, histology, and pathogen identification by culture or PCR.
As invasive aspergillosis is associated with significant morbidity and mortality early diagnosis and treatment is key.
