To describe the characteristics and management of non-transplant patients with invasive pulmonary aspergillosis (IPA).

The clinical manifestation, microbiological examination, chest imaging, diagnosis, treatment and outcomes of 32 non-transplant patients with IPA from Capital Medical University Affiliated Beijing Anzhen Hospital from January 2015 to August 2021 were retrospectively collected and described.

3 cases fulfilled the criteria of proven IPA, 27 of probable an 2 of possible IPA, and among the 32 patients. One case was primary IPA, and 31 cases were secondary IPA, among which chronic pulmonary diseases 20 cases(62.5%) and uses of glucocorticoid 10 cases(31.3%) were the most common basic diseases and risk factors. The main clinical manifestations included cough 30 cases(93.8%), sputum production 30 cases(93.8%), dyspnea 25 cases(78.1%), fever 16 cases(50.0%) and lung rales 23 cases(71.8%). The chest imaging mainly included patchy infiltrates 31 cases(96.8%), consolidation 21 cases(65.6%), nodules 20 cases(62.5%) and cavities 15 cases(46.8%). 28 cases with glucan(G)test, 19 cases positive plasme(67.9%). 16 cases with plasma galactomannan (GM) test, positive 11 cases(68.7%). 16 cases positive sputum cultures(50%), which mainly included Aspergillosis flavus and Aspergillosis fumigatus. All patients received Voriconazole, Amphotericin B, Amphotericin B Liposome and Caspofungin Acetate therapy alone or in combination and the total course of treatment was about 8-12 weeks. The mean length of stay was 20.5 days (2~123 days). 8 cases were cured, 14 cases improved, 4 cases failed and 6 cases died.

IPA in non-transplant patients is usually insidious at onset without specific manifestations. When clinically suspected, microbiological examination should be done as soon as possible, and graded treatment should be given according to hierarchical diagnosis to improve the prognosis.