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Other patients at risk undergo serum galactomannan testing three times weekly. At 72\u201396\u00a0h of persisting fever despite broad\u2010spectrum antibiotics, or at onset of lower respiratory tract symptoms a thoracic computed tomography (<jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content>) scan is performed. Without lung infiltrates on <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> IPA<\/jats:styled-content> is ruled out. In lung infiltrates not suggestive for <jats:styled-content style=\"fixed-case\">IPA<\/jats:styled-content> mycological confirmation is pursued. In patients without posaconazole prophylaxis empiric caspofungin will be considered. <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content> findings typical for <jats:styled-content style=\"fixed-case\">IPA<\/jats:styled-content> prompt targeted treatment, and mycological confirmation. Bronchoalveolar lavage (<jats:styled-content style=\"fixed-case\">BAL<\/jats:styled-content>) is most important for cultural identification and susceptibility testing, and facilitates diagnosing other pathogens. <jats:styled-content style=\"fixed-case\">BAL<\/jats:styled-content> performance is virtually independent of platelet counts. If despite suggestive infiltrates <jats:styled-content style=\"fixed-case\">BAL<\/jats:styled-content> does not yield the diagnosis, <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content>\u2010guided biopsy follows as soon as platelet counts allow. Surgery can also be beneficial in diagnosis and treatment of <jats:styled-content style=\"fixed-case\">IPA<\/jats:styled-content>. If the diagnosis of <jats:styled-content style=\"fixed-case\">IPA<\/jats:styled-content> is not established, mucormycosis is a valid concern. In patients with breakthrough <jats:styled-content style=\"fixed-case\">IPA<\/jats:styled-content> during posaconazole prophylaxis liposomal amphotericin B is the drug of choice. If no posaconazole prophylaxis was given, voriconazole is the treatment of choice for <jats:styled-content style=\"fixed-case\">IPA<\/jats:styled-content>.<\/jats:p>","DOI":"10.1111\/myc.12319","type":"journal-article","created":{"date-parts":[[2015,3,24]],"date-time":"2015-03-24T21:38:35Z","timestamp":1427233115000},"page":"375-382","source":"Crossref","is-referenced-by-count":23,"title":["Our 2015 approach to invasive pulmonary aspergillosis"],"prefix":"10.1111","volume":"58","author":[{"given":"B.","family":"Liss","sequence":"first","affiliation":[{"name":"Department I of Internal Medicine University Hospital of Cologne Cologne Germany"},{"name":"Center for Integrated Oncology CIO K\u00f6lnBonn University of Cologne Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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