Table 1.

Aspergillus -associated disease states

Disease	Clinical syndromes	Patient groups and notes
Invasive aspergillosis (IA): Most common species: A. fumigatus, A. flavus, A. niger, A. terreus, A. ustus, A. versicolor	Pneumonia and systemic disease; CNS disease most common site of dissemination; fungal keratitis	Induction-consolidation chemotherapy for hematologic malignancies and aplasia BM, lung, and heart transplant recipients Patients with graft vs. host disease, recipients of systemic corticosteroid therapy COPD and critically ill ICU patients Fungal keratitis in agricultural workers with corneal abrasions
Primary immune deficiencies associated with IA		Affected gene
Chronic granulomatous disease A. fumigatus and A. nidulans most common IA species in CGD	Pneumonia, deep tissue disease (e.g., osteomyelitis, brain abscess)	Defects in NADPH oxidase (e.g., in p22, p47, X-linked p91 subunits)
Job’s syndrome (HIES)	Pneumonia, lung disease at sites of prior bacterial (staphylococcal) lung abscess	STAT3
MonoMAC syndrome	Pneumonia	GATA2
CARD9 deficiency	Extrapulmonary aspergillosis	CARD9
Several Congenital Neutropenia	Pneumonia and systemic disease	ELA2, HAX1
Leukocyte adhesion deficiency	Pneumonia and systemic disease	CD18
Pulmonary alveolar proteinosis	Pneumonia and systemic disease	Defect in GM-CSF signaling and surfactant catabolism
Chronic pulmonary aspergillosis (includes SAIA, CNPA, CCPA)	Pneumonia in patients with structural and/or cavitary lung disease; no angioinvasion and hyphae confined to preexisting lung cavity	Affects individuals previously treated for TB Aspergilloma refers to a fungus ball, a clump of hyphae in a pulmonary cavity
Tracheobronchial aspergillosis	Fungal disease of large airways without evidence of lung parenchymal involvement	Most common in lung transplant recipients and ICU patients
Allergenic disease	ABPA	Patients with underlying asthma and cystic fibrosis have defective fungal clearance and dysregulated immune responses Hypersensitivity to Aspergillus antigens can lead to progressive bronchiectasis
	Extrinsic allergic alveolitis	Typically observed after very high exposure to airborne conidia

ABPA, allergic bronchopulmonary aspergillosis; BM, bone marrow; CARD9, caspase recruitment domain-containing protein 9; CCPA, chronic cavitary pulmonary aspergillosis; CGD, chronic granulomatous disease; CNPA, chronic necrotizing pulmonary aspergillosis; CNS, central nervous system; GATA2, GATA binding protein 2; GM-CSF, granulocyte-macrophage colony-stimulating factor; HIES, hyper IgE syndrome; LAD, leukocyte adhesion deficiency; SAIA, subacute invasive pulmonary aspergillosis; SCN, severe combined neutropenia; TB, tuberculosis.