This problem may be overstated, however. It is especially troubling if the species isolated is A. fumigatus or A. flavus . For both of these situations, I advocate preemptive amphotericin therapy. Blood cultures are usually negative but can be useful if positive. Serologic tests for antibody also have little diagnostic value.
Aggressive biopsy is required for early diagnosis and effective treatment in most patients.
Allergic Disease Acute bronchoconstriction in response to the inhalation of Aspergillus spores is noted in patients with atopic asthma. Another type of reaction affecting persons with atopic asthma is allergic bronchopulmonary aspergillosis, in which a mucosal defect results in colonization of the bronchial tree by the fungus. Ensuing symptoms are wheezing, fever, subsegmental pulmonary infiltrates, eosinophilia of sputum and blood, and precipitating antibodies against Aspergillus . Sputum is mucoid and contains macroscopic brownish plugs, which are actual Aspergillus fragments. If the process is not interrupted by glucocorticoid therapy, proximal saccular bronchiectasis and pulmonary fibrosis will develop.