Aspergillosis diagnostic criteria

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:  Haytham Allaham, M.D. [2]; Yazan Daaboul, M.D.; Serge Korjian M.D.

## Overview[edit | edit source]

Diagnostic criteria are available for allergic bronchopulmonary aspergillosis and for allergic fungal rhinosinusitis. Major and minor diagnostic criteria are based on clinical, laboratory, and radiological findings.

## Diagnostic Criteria[edit | edit source]

### Allergic Bronchopulmonary Aspergillosis[edit | edit source]

The following table shows the diagnostic criteria for allergic bronchopulmonary aspergillosis:

Major | Minor

|

* Asthma

* Presence of Aspergillus in sputum

* Roentgenographic fleeting pulmonary opacities

* Expectoration of brownish black mucus plugs

* Skin test positive for Aspergillus

* Delayed skin reaction to Aspergillus antigen

* Eosinophilia

* IgE in serum elevated (> 500 IU/mL)- revised 2024 criteria

* Central bronchiectasis

* Serums A fumigatus-specific IgG and IgE

* Precipitating antibodies (IgG) in serum

### Allergic Fungal Rhinosinusitis[edit | edit source]

The following table shows the 1994 Bent and Kuhn diagnostic criteria for allergic fungal rhinosinusitis:

Major | Minor

|

* Type I hypersensitivity

* Asthma

* Nasal polyposis

* Unilateral disease

* Characteristic CT findings (see here)

* Bone erosion

* Eosinophilic mucin without invasion

* Fungal cultures

* Positive fungal stain

* Charcot-Leyden crystals

* Serum eosinophilia

Table adapted from Bent JP 3rd, Kuhn FA. Diagnosis of allergic fungal sinusitis. Otolaryngol Head Neck Surg.1994 111(5):580-8[1]

* To make the diagnosis of allergic fungal rhinosinusitis, patients must meet ALL the major criteria.
* Minor criteria may support the diagnosis, but they are not considered diagnostic.

## References[edit | edit source]

1. ↑ Bent JP, Kuhn FA (1994). "Diagnosis of allergic fungal sinusitis". Otolaryngol Head Neck Surg. 111 (5): 580–8. PMID 7970796.