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Invasive aspergillosis is an increasing problem, yet there are few specific data on pediatric aspergillosis. The underlying patient diseases and treatments differ in children and adults, and there is a heterogeneity of invasive aspergillosis that extends to children. Although new diagnostic tools hold great promise for adult patients, it appears that they have limited usefulness in children without the appropriate testing. Antifungal management of pediatric aspergillosis also requires unique dosing schemes that are not used in adult patients.