Johns Hopkins HIV Guide

Aspergillus spp.

Dionissis Neofytos, M.D.; Paul G. Auwaerter, M.D.

MICROBIOLOGY

  • Ubiquitous filamentous mold, hyphae (2-5 µm) usually septated with 45° angle branching.
  • Diagnosis mainly based on colony morphology on solid media and specific microscopic features.
  • Non-invasive diagnostic tests now available: galactomannan antigen in serum and BAL (good sensitivity/specificity in the right patient population), PCR (not well studied), beta-D-glucan (not specific).
  • A. fumigatus most common cause of human disease. A. flavus next most common, followed by A. terreus, A. niger (usually a contaminant), A. versicolor, and A. nidulans. Recently, new Aspergillus spp. described (e.g. A. lentulus).
  • A. terreus may be resistant to amphotericin products. A. fumigatus: azole-resistance reported. A. lentulus: may be resistant to itraconazole, voriconazole, caspofungin.

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