Pulmonary Aspergillosis

Abstract

Pulmonary asper-gillosis can be difficult to diagnose. Aspergilli recovered from sputum may have no clinical significance, or cultures of sputum and bronchial secretions may be negative despite significant infection with aspergillus. A classification based on whether or not the infection is invasive is proposed. In 4 cases of invasive infection (2 fatal), diagnosis could be made only by culture of lung tissue. In 5 cases of noninvasive infection, infection was localized within an abscess cavity or bronchial cyst, the more common form of pulmonary aspergillosis. In 1 case, infection presented as a fungus ball without typical X-ray appearance. Host resistance is doubtless important in determining whether infection with aspergilli develops. Microscopic examination of tissues utilizing special staining techniques and recovery and identification of organism by tissue culture are necessary to diagnose aspergillosis indisputably.