Invasive pulmonary aspergillosis, part 1: Diagnosis

ABSTRACT: The diagnosis of invasive pulmonary aspergillosis remains challenging because of atypical clinical presentations, comorbid diseases, and the difficulty in culturing Aspergillus by standard microbiological techniques. Serial monitoring with CT scans of the chest and serological markers can help with early identification in high-risk patients, such as hematopoietic stem cell transplant recipients. The most common radiographic findings are single or multiple nodules, wedge-shaped pleural-based infiltrates, and cavities. The halo sign is the most suggestive clue to aspergillosis and is manifested by a macronodule surrounded by a perimeter of ground-glass opacity. (J Respir Dis. 2008;29(10):405-410)