Invasive aspergillosis in immunocompromised hosts: diagnostic and management challenges
Brennan J. Collis1# and Barbara D. Alexander1,2
1Department of Medicine, Division of Infectious Diseases, Duke University School of Medicine, Durham, NC, U.S.A.; 2Department of Pathology, Clinical Microbiology Laboratory, Durham, NC, U.S.A.
Abstract
Invasive aspergillosis (IA) is a life-threatening fungal infection that primarily affects immunocompromised individuals. The at-risk population continues to expand due to broader use of immunosuppressive therapies and increasing recognition of non-traditional risk groups. Diagnosis remains challenging due to the non-specific clinical features and limitations in the performance of current diagnostic tests. Although advances in antifungal agents and therapeutic strategies have led to improved outcomes, treatment failure and the emergence of antifungal resistance remain significant concerns. This review summarizes current knowledge on the clinical presentation, diagnosis, and management of IA, and highlights recent advances, persistent challenges, and priorities for future research.
Open Access
Cite this article:
Collis BJ, Alexander BD, 2025.
Invasive aspergillosis in immunocompromised hosts: diagnostic and management challenges One Health Mycology 2(1), 53-69
ISSN: 3050-4627
doi.org/10.63049/OHM.25.21.4
Keywords:
aspergillosis; Aspergillus; diagnosis; management; risk factors
Article highlights:
- Overview of established and emerging risk factors for IA across diverse high-risk patient populations.
- Review of the advantages and limitations of current diagnostic tests for IA.
- Summary of available evidence supporting antifungal agents in the management of IA, including investigational antifungals.
#Correspondence:
Brennan.Collis@duke.edu
Article info:
Received 1 March 2025
Revised 27 April 2025
Accepted 29 April 2025
Appeared online 14 May 2025
One Health Mycology 2(1): 53-69, 2025