Common fungal lung diseases, their estimated burden and required diagnostic tests
| Disorder | Context | Global burden | Key diagnostic |
|---|---|---|---|
| ABPA | Asthma | 4 800 000 | Aspergillus IgE, total IgE |
| Cystic fibrosis | 6675 | ||
| Severe asthma with fungal sensitisation | Asthma | >6 500 000 | Fungal IgE, skin allergy testing |
| Chronic pulmonary aspergillosis | Post-TB, COPD, sarcoidosis, NTM disease, post-pneumothorax, ABPA, rheumatoid arthritis etc | 1 200 000 after TB, 1 800 000 other disorders | Antibody, CXR, CT scan, microscopy, culture |
| Invasive aspergillosis | Leukaemia, transplantation, COPD, AIDS | >300 000 | Antigen, PCR detection, CT scan, microscopy, culture |
| Pneumocystis pneumonia | AIDS | >400 000 | PCR detection, microscopy |
| Immunocompromised | >100 000 | ||
| Endemic mycoses* | Non-immunocompromised | ?? | Antibody, culture, biopsy |
| Other invasive/opportunistic lung infections† | Immunocompromised, including AIDS | Microscopy 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.