Report from the 4th Advances Against Aspergillosis Conference.

Traditionally, the patients believed to be at highest risk of invasive aspergillosis (IA) are those who are neutropenic due to chemotherapy for hematological malignancy or those undergoing allogeneic hematopoietic stem cell transplantation. However, emerging data show that other patients are vulnerable to IA, even though some are not classically immunocompromised. These include: solid organ transplant recipients; patients with TB, chronic obstructive pulmonary disease and patients in the intensive care unit for other reasons. The conference highlighted the diagnostic and therapeutic challenges facing physicians treating this diverse group, not least of which include the unreliable estimates of IA incidence due to poor surveillance and inadequate data collection. Moreover, although there is now considerable experience of IA in neutropenic patients, much less is known about the management of those who are non-neutropenic. Nevertheless, approaches that have proven effective in neutropenic patients may also benefit others in this growing population. The meeting, attended by more than 500 delegates from almost 50 countries, also provided the opportunity to hear how basic scientific research may improve the understanding of the pathogenic mechanisms and therapy of IA.