🦠 Latest Aspergillosis Updates (Weeks 45 & 46)

Over the past two weeks, several new studies and reports have deepened understanding of aspergillosis – the group of lung and sinus infections or allergic diseases caused by Aspergillus moulds.
They cover new national guidance, emerging risk groups, drug interactions, and new ideas for diagnosis.

🔹 1. National Best-Practice Update (BSMM 2025)

What’s new:
The British Society for Medical Mycology (BSMM) has released its 2025 recommendations for diagnosing serious fungal diseases such as aspergillosis.
The update emphasises:

• using standardised blood and imaging tests across hospitals,

• improving access to specialist mycology laboratories,

• faster recognition in people with chronic lung disease, transplant, or immune suppression.

Why it matters:
Patients should receive the same high-quality diagnostic work-up wherever they are treated in the UK, reducing delays and missed cases.

🔹 2. Drug Interaction: Posaconazole + Olorofim

What’s new:
Researchers discovered that combining posaconazole (an existing antifungal) with olorofim (a new one still in trials) can cancel out each other’s effect in laboratory and animal tests.

Why it matters:
Doctors will avoid using these two together until proper studies confirm safety.
This ensures that new antifungal drugs are introduced carefully and responsibly, not just because they’re newer.

🔹 3. Invasive Aspergillosis in Non-Neutropenic Patients

What’s new:
Traditionally, invasive pulmonary aspergillosis (IPA) affected people with very low white-cell counts, such as cancer or transplant patients.
A new review shows that people without immune deficiency, including those in ICU, with COPD, or taking steroids, can also develop life-threatening infection.

Why it matters:
Clinicians are being urged to consider aspergillosis sooner when patients with chronic lung disease suddenly deteriorate or fail to respond to antibiotics.

🔹 4. Severe Case in Acute Liver Failure

What’s new:
A case report describes aspergillosis spreading in a patient with acute liver failure, detected by endoscopy rather than usual lung imaging.

Why it matters:
Highlights that aspergillosis can start outside the lungs and that liver-failure patients may have hidden fungal infection even without classic risk factors.

🔹 5. Post-Partum Aspergillus flavus Infection

What’s new:
A rare infection occurred soon after childbirth, caused by Aspergillus flavus rather than the usual A. fumigatus.

Why it matters:
Shows that pregnancy and recovery can temporarily lower resistance to infection.
Unusual breathlessness or fever after delivery deserves careful investigation.

🔹 6. Immune Markers for Chronic and Allergic Forms (CPA and ABPA)

What’s new:
Researchers have mapped immune-system signals (biomarkers) that could help diagnose or monitor chronic pulmonary aspergillosis (CPA) and allergic bronchopulmonary aspergillosis (ABPA) when scans or sputum tests are inconclusive.

Why it matters:
These blood-based tests could make diagnosis faster, less invasive, and more consistent – especially where bronchoscopy isn’t possible.

🧩 The Big Picture

👥 What this means for you

• Patients: if you have asthma, COPD, bronchiectasis, or another chronic lung problem and suddenly feel worse or don’t improve on antibiotics, ask whether aspergillosis has been considered.
  Modern tests can often detect it from a blood sample.

• GPs and non-specialist staff: awareness is key. These studies stress early suspicion, use of mycology testing, and following the BSMM 2025 guidance for timely referral.

• Researchers: note the priority areas – drug-interaction monitoring, immune-marker validation, and cross-disciplinary education between hepatology, ICU, obstetrics, and respiratory medicine.

🔗 Further reading

• BSMM 2025 Best Practice Recommendations — Lancet Infect Dis (2025)

• Posaconazole–Olorofim Interaction — J Antimicrob Chemother (2025)

• IPA in Non-Neutropenic Patients — Clin Infect Dis (2025)

• Immune Markers in CPA & ABPA — Front Immunol (2025)
  Full links: 1 | 3 | 4 | 6