Table 1

Common fungal lung diseases, their estimated burden and required diagnostic tests

DisorderContextGlobal burdenKey diagnostic
ABPAAsthma4 800 000Aspergillus IgE, total IgE
Cystic fibrosis6675
Severe asthma with fungal sensitisationAsthma>6 500 000Fungal IgE, skin allergy testing
Chronic pulmonary aspergillosisPost-TB, COPD, sarcoidosis, NTM disease, post-pneumothorax, ABPA, rheumatoid arthritis etc1 200 000 after TB, 1 800 000 other disordersAntibody, CXR, CT scan, microscopy, culture
Invasive aspergillosisLeukaemia, transplantation, COPD, AIDS>300 000Antigen, PCR detection, CT scan, microscopy, culture
Pneumocystis pneumoniaAIDS>400 000PCR detection, microscopy
Immunocompromised>100 000
Endemic mycoses*Non-immunocompromised??Antibody, culture, biopsy
Other invasive/opportunistic lung infections†Immunocompromised, including AIDSMicroscopy antigen, culture, biopsy
  • *Endemic mycoses = cocccidioidomycosis, histoplasmosis, blastomycosis, paracocccidioidomycosis in non-immunocompromised patients.

  • †Mucormycosis, cryptococcal pneumonia, histoplasmosis, coccidioidomycosis.

  • ABPA, Allergic bronchopulmonary aspergillosis; CXR, chest radiograph; NTM, non-tuberculous mycobacterial infection; TB, pulmonary tuberculosis.