Clinical Problem Solving: Invasive Aspergillosis Can Exist Even If Serum Galactomannan is False Positive!

Abstract Influenza-Associated Pulmonary Aspergillosis (IAPA) is a serious and often underdiagnosed fungal complication that can arise in patients with severe influenza, particularly those requiring intensive care. While not definitive alone, serological markers are valuable in conjunction with clinical, radiological, and microbiological findings to support timely diagnosis and guide antifungal therapy. Diagnosing IPA in non-neutropenic hosts, particularly those nearing endotracheal intubation and in whom bronchoscopy is contraindicated, presents a significant clinical challenge.