The gold standard for diagnosis of aspergillosis is a combination of clinical, radiologic, and microbiologic lab testing. Clinical signs of aspergillosis include coughing, wheezing, chest pain, shortness of breath, fever, and fatigue. Radiologic testing such as chest X-rays and CT scans can help to detect pulmonary nodules, cavities, and pleural effusions. Microbiologic testing includes sputum and bronchoalveolar lavage cultures and histopathological examination of lung tissue.
Serologic testing can also be used to diagnose aspergillosis, but it is not considered to be part of the gold standard. Serologic testing can detect antibodies to Aspergillus antigens, which can help confirm the diagnosis of aspergillosis. However, false positives are possible and serologic tests can be unreliable in certain cases.
Finally, molecular testing is available and can detect Aspergillus DNA in tissue samples. This test is highly sensitive, but it may not be able to differentiate between Aspergillus species, which can cause different types of aspergillosis.
In summary, the gold standard for diagnosis of aspergillosis is the combination of clinical, radiologic, and microbiologic lab testing. Serologic and molecular testing can be used to supplement the diagnosis, but they are not considered to be part of the gold standard.