Challenges in Diagnosing Invasive Pulmonary Aspergillosis in Patients With COPD and Other Chronic Lung Disorders

Abstract

Invasive pulmonary aspergillosis (IPA) is a necrotizing pneumonia caused by airborne opportunistic fungi of Aspergillus species. Patients with chronic obstructive pulmonary disease (COPD) or other chronic lung disorders (CLD) have emerged to be at risk for IPA, with a related mortality rate greater than 70%. Host factors playing a role in the occurrence of IPA in CLD patients differ from those in patients with hematologic disorders and may be largely responsible for a distinct pattern of the disease. Furthermore, these host factors affect the results of standard diagnostic procedures recommended for IPA. Therefore, the diagnosis of IPA in patients with COPD and other CLD remains challenging for physicians. This review puts into perspective the host factors contributing to the pathogenesis of IPA in CLD patients and discusses the use and interpretation of the main diagnostic tools currently available.