Those who are immunocompromised due to extreme prematurity, or severe underlying illness. Patients undergoing prolonged, high dose corticosteroid treatment such as that given to rheumatology patients. Establish a case definition for active surveillance of cases of pulmonary aspergillosis Diagnosis of invasive pulmonary aspergillosis is difficult. Isolation of Aspergillus spp. Additionally, patients with invasive disease may have negative cultures.
Blood cultures are unreliable.
Definitive diagnosis of invasive aspergillosis usually requires biopsy of the involved tissue. It is important to consider the clinical picture when searching for cases. For example, in a granulocytopenic patient with fever, a new pulmonary infiltrate, and Aspergillus spp. Any patient with Aspergillus spp. isolated by culture and no clinical evidence of fungal infection. Maintain active surveillance A. Maintain a high index of suspicion for the diagnosis of nosocomial pulmonary aspergillosis in high-risk patients.