Evidence-based approach to challenging issues in the management of invasive aspergillosis.

The management of invasive aspergillosis continues to pose challenging issues. The review herein focuses on our evolving knowledge base with regards to the evolution of disease upon initiation of antifungal therapy, approach to worsening disease despite seemingly adequate therapy, and therapeutic considerations in the prescription of antifungal agents for invasive aspergillosis in patients receiving iatrogenic immunosuppressants. Evidence-based studies are still needed to resolve critical issues pertaining to combination therapy.