Clinical Presentation

The clinical presentation depends on the site(s) of infection. Respiratory symptoms such as dyspnea, cough, pleuritic chest pain, and fever predominate. Hemoptysis is a sign of invasive disease. Aspergillus disseminates to the brain, liver, spleen, kidneys, heart, blood vessels, bone, joints, and gastrointestinal tract.

The diagnosis of invasive infection with Aspergillus relies on the isolation of the organism in the appropriate setting; histopathology of biopsy specimens is required to determine invasiveness when this mold is recovered from respiratory specimens. CT imaging is helpful in evaluating lung disease, and CNS imaging by CT and MR will delineate brain abscesses. The isolation of Aspergillus species from the respiratory secretions of any transplant recipient requires a prompt and thorough investigation to exclude invasive infection; this is especially true for lung allograft recipients.

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