Abstract
Pulmonary aspergillosis (PA) is an umbrella terms for a range of diseases developing due to the presence of fungi of the genus Aspergillus in the lungs; depending on the relationship between a fungus and the host's immune system condition, various clinical forms of the disease develop - aspergillosis syndromes. There are three types of PA with different pathogenesis, risk factors for the development, clinical manifestations and treatment approaches.
The first subgroup is allergic bronchopulmonary aspergillosis, a manifestation of frequent hypersensitivity to Aspergillus. The second subgroup comprises chronic pulmonary aspergillosis, characterized by saprophytic noninvasive colonization of preformed cavities in the airways (aspergilloma), and local invasive forms (subacute invasive aspergillosis) with progressive cavity formation.
The third subgroup is invasive pulmonary aspergillosis, represented by either a locally invasive (bronchoinvasive) form (invasive Aspergillus tracheobronchitis), a complication following transplantation of solid organs, in particular the lungs, or an angioinvasive form typical for granulocytopenic patients after hematopoietic cell transplantation which is associated with a risk for generalization of the infection. Each of the above entities is characterized by basic clinical data and the diagnostic and treatment algorithms.
Also listed are diagnostic options and the role of individual methods in the diagnosis of PA, including the key role of bronchoalveolar lavage.