Would you recommend anti-fungal treatment for aspergillus infection for a patient with an incidental finding of worsening ground glass opacities and enlarging nodules on CT chest with positive BAL galactomannan, elevated aspergillus IgE and IgG in an otherwise immunocompetent host with no respiratory symptoms?

No, I would not recommend antifungal treatment in this case. The patient, as described, does not seem to have invasive aspergillosis, chronic necrotizing aspergillosis, or allergic bronchopulmonary aspergillosis, so I don't believe antifungal treatment is indicated.

There may be other details of the...

This question brings up the strange, somewhat artificial situation in which someone has had serial CT chests (but we don't know why), has already had a bronchoscopy with BAL, and has been presumed immunocompetent (without us knowing how much workup has been done to prove that). There is a lot we'd l...