What follow-up strategies should be implemented for patients treated for aspergillosis to monitor for recurrence or complications?

Follow-up strategies for patients treated for aspergillosis should include:

• Regular clinical assessment to monitor symptoms and detect any signs of recurrence or complications.
• Repeat respiratory sample cultures to monitor for persistent or recurrent Aspergillus infection, especially in patients with chronic respiratory conditions such as cystic fibrosis.
• Consideration of imaging studies (e.g., chest X-ray or CT scan) to evaluate for consistent changes suggestive of aspergillus airway disease or allergic bronchopulmonary aspergillosis, particularly if pulmonary function declines despite optimized treatment.
• Specialist microbiological advice should be sought to guide antifungal therapy and to decide on continuation, change, or cessation of treatment based on clinical response.
• Monitoring of pulmonary function to detect decline that may indicate recurrence or complications.

These strategies aim to detect recurrence early and manage complications effectively, tailoring treatment based on clinical and microbiological findings.

References: NICE NG78