Progress in the Diagnosis and Treatment of Pulmonary Aspergillosis
Aspergillus is the most common fungal pathogen of the respiratory mycosis. The respiratory diseases caused by
Aspergillus are mainly classified into four clinical types, namely allergic bronchopulmonary aspergillosis, invasive
aspergillosis, aspergilloma, and chronic pulmonary aspergillosis. Among the four clinical types of pulmonary
aspergillosis, invasive aspergillosis is the most dangerous and difficult to treat disease. The diagnosis of invasive
aspergillosis is established initially on clinical aspects and confirmed by the finding of pathogen in culture and
histopathology. A number of methods can be conducted to obtain tissue samples from patients with invasive aspergillosis,
chronic pulmonary aspergillosis or aspergilloma. Besides BAL detection and transbronchial biopsy, a fine-needle biopsy
can be performed and guided by CT to diagnose these diseases. Antifungal agents including those with activity against
Aspergillus have been developed. Several agents such as voriconazole, amphotericin B lipid complex, caspofungin,
micafungin and anidulafungin are promising in the treatment of the pulmonary aspergillosis in the future. Moreover,
under certain condition, surgical intervention is needed to combine with antifungal therapy to deal with aspergilloma or
chronic pulmonary aspergillosis, and the use of glucocorticoids to control the inflammatory response is also very
important in therapy of allergic bronchopulmonary aspergillosis besides antifungal agents.
Keywords: Allergic bronchopulmonary aspergillosis, aspergilloma, chronic pulmonary aspergillosis, invasive aspergillosis.
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