Invasive pulmonary aspergillosis in critically ill COPD patients

You may be used to thinking of Aspergillus as a neutrophil opportunist. However, it can cause invasive disease in COPD patients whose immune deficits consist of impaired local defenses, corticosteroid use (high cumulative doses) and the use of multiple antibiotics. If you encounter new or progressive infiltrates in a COPD patient recently treated with broad spectrum antibiotics and high cumulative doses of corticosteroids, think of it.