Diagnosis of invasive pulmonary aspergillosis in the intensive care unit: what we should concern and how to do better

Invasive pulmonary aspergillosis (IPA) is no longer a rare disease in the intensive care unit (ICU) on account of the increased number of immunocompromised hosts admitted, the application of invasive treatment procedures and the widespread use of broad-spectrum antibiotics. Different from those with agranulocytosis, symptoms and signs of IPA in ICU patients are subtle or non-specific which are unable to be distinguished from those with bacterial pneumonia or even with noninfectious diseases. Thus, accurately diagnosing of IPA is quite challenging. In this review, we will navigate through the IPA diagnostic tests currently available and how they apply to ICU population. Special attention is paid to the non-culture- based tests as well as have a look into what the future holds.