INVASIVE PULMONARY ASPERGILLOSIS: RISK FACTORS, DIAGNOSIS AND TREATMENT PRINCIPLES

Invasive pulmonary aspergillosis is a fungal infection that typically affects immunocompromised patients. The infection in question is caused by spores of the genus Aspergillus inhaled into the lungs. Aspergillosis manifestations may take a variety of different forms, although this is highly linked to the origin of the immunodeficiency status. Besides not only cancers or AIDS, but patients treated for liver disease, transplantation, long-term use of steroids and critical conditions may be responsible for severe immunosuppression as well. The diagnosis of invasive pulmonary aspergillosis is complex and based on the clinical context: symptoms that are normally not specific, comorbidities, medications, surgery or other factors in a history of life that potentially affected immunosuppression. It also refers to radiological findings from imaging, infectious markers and microbiological histopathology from bronchoalveolar lavage (BAL) specimens. Particular attention shall be paid to the biochemical examination of the infectious marker for galactoman, which may be carried out not only from blood serum but also from BAL samples. In addition, due to the potential drug resistance, it is important to assess antifungal susceptibility to ensure effective treatment. The first option for treatment of invasive pulmonary aspergillosis is Voriconazole, but for various reasons Fluconazole or amphotericin B may be used as an alternative.