Aspergillus infections

Aspergillus infections affect persons with various levels of immune system competence or compromise. Since 2009, molecular studies have identified new polymorphisms that predispose some persons to disease. New risk factors for aspergillosis include ICU stays and respiratory viral infections. Clinicians are linking new diagnoses of invasive aspergillosis to evolving therapies for various medical conditions. For example, monoclonal antibodies and tyrosine kinase inhibitors have been developed to treat underlying disease and avoid glucocorticoid-induced immunosuppression. If invasive infection is suspected, clinicians can perform noninvasive diagnostic testing to supplement radiographic imaging, so that treatment can be initiated as early as possible in the course of infection. Clinicians can add prophylaxis against a new aspergillus infection in high-risk situations. With multiple classes of antifungal agents available for treatment, clinicians have options to assist infected patients with recovery. Good outcomes depend largely on reversal of immunosuppression, early administration of antifungal therapy, and surgical drainage in selected cases.