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Aspergilosis

Last reviewed: 21 Aug 2025
Last updated: 17 Apr 2024

Summary

Definition

History and exam

Key diagnostic factors

  • presencia de factores de riesgo
  • dolor torácico pleurítico
  • roce pleural
  • úlcera nasal
  • erupción cutánea
Full details

Other diagnostic factors

  • tos
  • cefalea
  • fiebre
  • congestión o sensibilidad sinusal
  • hemoptisis
  • disnea
  • dolor facial
  • convulsión
  • alteración del estado mental
  • parálisis de pares craneales
  • malestar general
  • pérdida de peso
Full details

Risk factors

  • trasplante alogénico de células madre
  • neutropenia grave prolongada (>10 días)
  • terapia inmunosupresora
  • enfermedad granulomatosa crónica (EGC)
  • trasplante de órgano sólido (TOS)
  • leucemia aguda
  • anemia aplásica
  • enfermedad pulmonar anterior o actual
  • enfermedad pulmonar crónica avanzada
  • infección gripal.
  • Infección por COVID-19
  • inmunodeficiencia primaria
  • Infección por VIH
  • diabetes mellitus
  • fibrosis quística
  • quemaduras graves
  • desnutrición
  • mieloma múltiple
  • pacientes inmunocompetentes
  • edad >55 años
  • tabaquismo
Full details

Diagnostic tests

1st tests to order

  • radiografía del tórax (RT)
  • exploración por tomografía computarizada (TC) de tórax de alta resolución
  • exploración de senos por tomografía computarizada (TC) de alta resolución
  • exploración por tomografía computarizada (TC) cerebral de alta resolución
  • imagen por resonancia magnética (IRM) de los senos
  • imagen por resonancia magnética (IRM) cerebral
  • antígeno galactomanano (GM) de Aspergillus sérico por enzimoinmunoanálisis (EIA)
  • cultivo de esputo
  • frotis de esputo
Full details

Tests to consider

  • antígeno galactomanano (GM) de Aspergillus en LBA
  • broncoscopía con lavado broncoalveolar (LBA) tinción para aislamiento de hongos
  • broncoscopía con cultivo fúngico de lavado broncoalveolar (LBA)
  • reacción en cadena de la polimerasa
  • beta-D-glucano sérico (1-3)
  • IgG de Aspergillus en suero
  • biopsia de tejido
  • cultivo fúngico tisular
  • tinción tisular para aislamiento de hongos
Full details

Treatment algorithm

INITIAL

sospecha de aspergilosis invasiva

ACUTE

aspergilosis invasiva confirmada

aspergiloma con hemoptisis potencialmente mortal

ONGOING

aspergilosis pulmonar crónica

Contributors

Authors

Mayur Ramesh, MD
Mayur Ramesh

Senior Consultant

Division of Infectious Diseases

Henry Ford Hospital

Detroit

MI

Disclosures

MR declares that he has no competing interests.

Pranatharthi Chandrasekar, MD
Pranatharthi Chandrasekar

Professor

Division of Infectious Diseases

Wayne State University

Detroit

MI

Disclosures

PC is an author of references cited in this topic.

Peer reviewers

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

Artigos de referência

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

    • Mucormicosis y otras cigomicosis (p. ej., ficomicosis, basidiobolomicosis)
    • 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
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