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

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

Allergic Bronchopulmonary Aspergillosis

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

Major Minor
  • Presence of Aspergillus in sputum
  • Expectoration of brownish black mucus plugs
  • IgE in serum elevated (> 500 IU/mL)- revised 2024 criteria
  • Serums A fumigatus-specific IgG and IgE

Allergic Fungal Rhinosinusitis

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

Major Minor
  • Unilateral disease
  • Characteristic CT findings (see here)
  • Bone erosion
  • Eosinophilic mucin without invasion
  • Fungal cultures
  • Positive fungal stain

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

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