When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Aspergillosis

Última revisão: 4 Aug 2025
Última atualização: 17 Apr 2024

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • pleuritic chest pain
  • pleural rub
  • nasal ulcer
  • skin rash
Detalhes completos

Outros fatores diagnósticos

  • cough
  • headache
  • fever
  • congestion or sinus tenderness
  • hemoptysis
  • dyspnea
  • facial pain
  • seizure
  • altered mental status
  • cranial nerve palsy
  • malaise
  • weight loss
Detalhes completos

Fatores de risco

  • allogeneic stem cell transplantation
  • prolonged severe neutropenia (>10 days)
  • immunosuppressive therapy
  • chronic granulomatous disease (CGD)
  • solid organ transplantation (SOT)
  • acute leukemia
  • aplastic anemia
  • prior or current lung disease
  • advanced chronic lung disease
  • influenza infection
  • COVID-19 infection
  • primary immunodeficiency
  • HIV infection
  • diabetes mellitus
  • cystic fibrosis
  • severe burns
  • malnutrition
  • multiple myeloma
  • immunocompetent patients
  • age >55 years
  • smoking
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • CXR
  • high-resolution chest CT scan
  • high-resolution sinuses CT scan
  • high-resolution brain CT scan
  • MRI sinuses
  • MRI brain
  • serum Aspergillus galactomannan (GM) antigen by enzyme immunoassay (EIA)
  • sputum culture
  • sputum smear
Detalhes completos

Investigações a serem consideradas

  • BAL Aspergillus galactomannan (GM) antigen
  • bronchoscopy with bronchoalveolar lavage (BAL) fungal stain
  • bronchoscopy with BAL fungal culture
  • polymerase chain reaction
  • serum (1-3)-beta-D-glucan
  • serum Aspergillus IgG
  • tissue biopsy
  • tissue fungal culture
  • tissue fungal stain
Detalhes completos

Algoritmo de tratamento

Inicial

suspected invasive aspergillosis

AGUDA

confirmed invasive aspergillosis

aspergilloma with life-threatening hemoptysis

CONTÍNUA

chronic pulmonary aspergillosis

Colaboradores

Autores

Mayur Ramesh, MD
Mayur Ramesh

Senior Consultant

Division of Infectious Diseases

Henry Ford Hospital

Detroit

MI

Declarações

MR declares that he has no competing interests.

Pranatharthi Chandrasekar, MD
Pranatharthi Chandrasekar

Professor

Division of Infectious Diseases

Wayne State University

Detroit

MI

Declarações

PC is an author of references cited in this topic.

Revisores

Daniel Friedman, MD

Assistant Professor of Medicine

Section of Infectious Diseases and Global Health

University of Chicago

Chicago

IL

Declarações

DM declares that he has no competing interests.

Paul Verweij, MD

Professor of Medical Microbiology

Department of Medical Microbiology

Radboud University

Nijmegen

The Netherlands

Declarações

Not disclosed.

Changa Kurukularatne, MD

Attending Physician/Consultant

Ochsner Medical Center

Department of Infectious Diseases

New Orleans

LO

Declarações

CK is a member of the Speakers Bureau for Pfizer Inc., the manufacturer of voriconazole and anidulafungin.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

Barnes PD, Marr KA. Aspergillosis: spectrum of disease, diagnosis, and treatment. Infect Dis Clin North Am. 2006 Sep;20(3):545-61, Resumo

Patterson TF, Thompson GR 3rd, Denning DW, et al. Practice guidelines for the diagnosis and management of aspergillosis: 2016 update by the Infectious Diseases Society of America. Clin Infect Dis. 2016 Aug 15;63(4):e1-e60.Texto completo  Resumo

Denning DW, Cadranel J, Beigelman-Aubry C, et al. Chronic pulmonary aspergillosis: rationale and clinical guidelines for diagnosis and management. Eur Respir J. 2016 Jan;47(1):45-68.Texto completo  Resumo

Kosmidis C, Denning DW. The clinical spectrum of pulmonary aspergillosis. Thorax. 2015 Mar;70(3):270-7.Texto completo  Resumo

Ullmann AJ, Aguado JM, Arikan-Akdagli S, et al. Diagnosis and management of Aspergillus diseases: executive summary of the 2017 ESCMID-ECMM-ERS guideline. Clin Microbiol Infect. 2018 May;24 Suppl 1:e1-e38.Texto completo  Resumo

Hope WW, Walsh TJ, Denning DW. Laboratory diagnosis of invasive aspergillosis. Lancet Infect Dis. 2005 Oct;5(10):609-22. Resumo

Maghrabi F, Denning DW. The management of chronic pulmonary aspergillosis: the UK National Aspergillosis Centre approach. Curr Fungal Infect Rep. 2017;11(4):242-51.Texto completo  Resumo

Limper AH, Knox KS, Sarosi GA, et al; American Thoracic Society Fungal Working Group. An official American Thoracic Society statement: Treatment of fungal infections in adult pulmonary and critical care patients. Am J Respir Crit Care Med. 2011 Jan 1;183(1):96-128.Texto completo  Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
  • Aspergillosis images
  • Diagnósticos diferenciais

    • Mucormycosis and other zygomycoses (e.g., phycomycosis, basidiobolomycosis)
    • Fusariosis
    • Scedosporiosis
    Mais Diagnósticos diferenciais
  • Diretrizes

    • Revision and update of the consensus definitions of invasive fungal disease
    • Microbiological laboratory testing in the diagnosis of fungal infections in pulmonary and critical care practice
    Mais Diretrizes
  • padlock-lockedConectar-se ou assinar para acessar todo o BMJ Best Practice

O uso deste conteúdo está sujeito ao nosso aviso legal