Clinical diagnosis of invasive pulmonary aspergillosis in a non-neutropenic critically ill patient.

Invasive pulmonary aspergillosis (IPA) is a life-threatening fungal infection that predominantly affects severely immunocompromised patients, particularly those with prolonged neutropenia or organ transplantation.1 Definitions have been developed that facilitate the diagnosis of IPA in immunocompromised patients with cancer or hematologic malignancy.2 Subsequent publications explored IPA in nonimmunocompromised patients in ICUs.3,4 In this specific setting, diagnosis of IPA is challenging for several reasons: it is a relatively uncommon condition, clinical presentation may be unspecific and mimic ventilator-associated pneumonia, and specific radiological and microbiological findings may be delayed. To highlight the difficulties of IPA diagnosis in the ICU, we present the case of an 82-y-old ICU patient without immunosuppression affected by possible IPA.