Invasive Aspergillosis Masquerading as Multiple Pulmonary Nodules: A Challenging Diagnosis

Invasive pulmonary aspergillosis (IPA) is an aggressive fungal infection of the lungs characterized by tissue invasion by fungal hyphal elements. The definitive diagnosis is challenging because it relies on histopathological demonstration of fungal elements, and these days clinicians are relying more on bronchoalveolar lavage (BAL) cultures and serum biomarkers (galactomannan and beta-D-glucan). We would like to emphasize through our case the necessity to keep a high index of suspicion for IPA despite negative cultures and serum biomarkers in immunosuppressed patients and consider surgical biopsy early.