For a study, it was determined that invasive pulmonary aspergillosis (IPA) became more well recognized as a serious illness in critically sick individuals who did not have traditional immunodeficiency risk factors. Background lung illness, such as chronic obstructive pulmonary disease, and corticosteroid treatment, even for a short period of time, had been the most relevant risk factors in the population. 

Since established standards for the diagnosis of IPA were designed for immunocompromised patients and had not been verified in immunocompetent critically sick patients, diagnosing IPA in critically ill patients was particularly challenging. A new IPA diagnostic method was verified in critically sick patients, and while it may be beneficial, it was not without flaws. As a result, a high level of suspicion was necessary. In non-neutropenic critically sick patients, IPA detection using serum galactomannan antigen and the β-d-glucan test was of little use. The lateral-flow device test, on the other hand, could be a valuable diagnostic tool for the identification of IPA in critically sick patients. 

Voriconazole was still the first-line treatment for suspected IPA, and it should be given even if a proven histologic diagnosis wasn’t feasible in critically sick patients because of their general condition.

Reference:journals.lww.com/clinpulm/Abstract/2016/07000/Invasive_Pulmonary_Aspergillosis_in_Critically_Ill.6.aspx