The following points are noteworthy. 1) IPA may be upgraded when other diagnostic tests are available. 2) Treatment for proven and probable IPA are, first choice: voriconazole; second: caspofungin; and third: lipid formulation of Amphotericin B deoxycholate. 3) In the case of possible IPA, close follow-up and consider additional diagnostic procedures, such as imaging, flexible bronchoscopy, techniques to obtain histology if possible, should be caried out. ND: not done; CPA: chronic pulmonary aspergillosis 23. +: positive; -: negative. ^#: Antibiotic-resistant exacerbation, pneumonia, pneumonitis or bronchospasm, typically in COPD Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage III or IV and currently or recently in receipt of corticosteroids. ^¶: Distinctive findings more obvious on thoracic computed tomography scan and include one or more cavities, new nodules or pleural-based lesions typical of pulmonary infarction. ⁺: Dichotomous (45°) branching septate hyaline hyphae. ^§: PCR result can be accepted when licensed. ^ƒ: Beware of false positives with some antibiotics, especially piperacillin/tazobactam. ^##: Consider alternative diagnosis, such as malignancy or other infections, e.g. cryptococcal or coccidioidal infection. ^¶¶: Consider alternative diagnosis such as mycobacterial or other fungal infections. ^§§: This result may be a standard culture or PCR result from another respiratory tract sample or from the biopsy or an immunology method of PCR specific to Aspergillus.