Mid-March 2026 Literature Update
This update summarises notable recent publications mentioning aspergillosis, prioritising studies relevant to chronic pulmonary aspergillosis (CPA), allergic bronchopulmonary aspergillosis (ABPA), diagnostics, epidemiology and management.
Table of Contents
Key Highlights
- Pulmonary aspergilloma review published in CHEST: a substantial review summarises modern understanding of pulmonary aspergilloma, including diagnosis, haemoptysis risk and management.
- Rapid diagnostic technologies emerging: new CRISPR-based and LAMP molecular approaches show promise for faster identification of Aspergillus fumigatus and antifungal resistance.
- Nebulised antifungal therapy explored for ABPA: a case report describes inhaled antifungal therapy in a patient with treatment-limiting comorbidities.
- Microbiome disruption may increase susceptibility to Aspergillus infection: experimental data suggest antibiotics can impair neutrophil-mediated antifungal immunity.
- Global burden continues to emerge: recent studies again show Aspergillus infection in patients initially suspected of tuberculosis or pneumonia.
Clinical and Review Papers
Pulmonary Aspergilloma: Comprehensive Clinical Review
Seo C, Dumoulin E, Thornton CS.
Spore Wars: A Comprehensive Review of Pulmonary Aspergilloma and Its Clinical Management.
CHEST, 12 Mar 2026.
PubMed: https://pubmed.ncbi.nlm.nih.gov/41831523/
This review provides an updated overview of pulmonary aspergilloma, covering pathogenesis, imaging findings, haemoptysis risk and current management strategies.
- Aspergilloma develops in pre-existing lung cavities, often related to previous tuberculosis or other structural lung disease.
- The major complication is haemoptysis, which can be severe or life-threatening.
- Management may include monitoring, antifungal therapy, bronchial artery embolisation or surgical resection in selected patients.
Systematic Review Planned on ABPA Therapies
Nwankwo L, Maidment I, Periselneris J, Jackson DJ, Agarwal R, Asano K, Nuh A, Ni M, Shah A, Armstrong-James D.
Protocol for a systematic literature review and network meta-analysis of the evidence for therapies in allergic bronchopulmonary aspergillosis (ABPA).
Systematic Reviews, 11 Mar 2026.
PubMed: https://pubmed.ncbi.nlm.nih.gov/41814377/
This protocol sets out a planned network meta-analysis comparing therapies used in ABPA.
- Will assess the evidence for oral corticosteroids, antifungal therapy, biologics and combination approaches.
- Aims to address the continuing lack of strong comparative evidence between treatment strategies.
Diagnostics and Detection Advances
Rapid Antifungal Susceptibility Testing for Aspergillus fumigatus
Nozue S, Furuhashi K, Toguchi A, Ishikawa J, Nagura O, Yamashita K, Maekawa M, Iwaizumi M.
Rapid antifungal susceptibility testing for Aspergillus fumigatus using a loop-mediated isothermal amplification method.
Journal of Microbiological Methods, 12 Mar 2026.
PubMed: https://pubmed.ncbi.nlm.nih.gov/41831694/
This study describes a loop-mediated isothermal amplification (LAMP) method for rapid antifungal susceptibility testing.
- Designed to identify antifungal resistance more quickly than conventional culture-based testing.
- Potentially useful for early recognition of azole resistance.
CRISPR-Based Detection of Aspergillus fumigatus
Jiang Q, Zeng X, Zhang Q, Yang F, Lv T, Zhang Y, Wang J, Li F, Xu D.
Development and application of a rapid detection system for Aspergillus fumigatus based on ERA/CRISPR-Cas12a.
BMC Microbiology, 9 Mar 2026.
PubMed: https://pubmed.ncbi.nlm.nih.gov/41803678/
This paper reports a rapid molecular detection platform combining ERA amplification with CRISPR-Cas12a.
- Aims to detect A. fumigatus DNA rapidly and accurately.
- Represents the wider move toward faster molecular fungal diagnostics.
Sputum Galactomannan for Diagnosing IPA in COPD
Lan Y, Li H, Su D, Liao X, Zhang Q, Ma Q.
Clinical value of sputum galactomannan testing in the diagnosis of invasive pulmonary aspergillosis among chronic obstructive pulmonary disease patients.
European Journal of Medical Research, 9 Mar 2026.
PubMed: https://pubmed.ncbi.nlm.nih.gov/41803989/
This study evaluates sputum galactomannan as a less invasive diagnostic tool for invasive pulmonary aspergillosis in patients with COPD.
- Could provide useful diagnostic information when bronchoscopy is not feasible.
- May complement serum or bronchoalveolar lavage-based testing.
Immunology and Pathogenesis
Antibiotics and Susceptibility to Aspergillus Infection
Aufiero MA, Hohl TM.
Antibiotic-induced microbiota disruption impairs neutrophil-mediated immunity to respiratory Aspergillus fumigatus infection in mice.
mBio, 11 Mar 2026.
PubMed: https://pubmed.ncbi.nlm.nih.gov/41810941/
This experimental paper suggests that antibiotic-driven microbiome disruption can impair neutrophil responses and increase vulnerability to Aspergillus infection.
- Antibiotics altered microbial communities in ways that weakened antifungal immunity.
- The findings support a protective role for the microbiome in respiratory host defence.
Therapeutic Developments
Nebulised Antifungal Therapy in ABPA
Carrasco Sánchez M, Llopis Pastor E, García-Salmones Martín M.
Nebulised antifungal therapy in allergic bronchopulmonary aspergillosis in a patient with treatment-limiting comorbidities.
Medicina Clínica (Barcelona), 12 Mar 2026.
PubMed: https://pubmed.ncbi.nlm.nih.gov/41832814/
This case report describes use of nebulised antifungal therapy in ABPA where standard systemic treatment was limited by comorbidities.
- Suggests inhaled delivery may occasionally offer a practical workaround in selected patients.
- Evidence remains limited and this should still be viewed as a niche or exploratory approach.
Epidemiology and Public Health
Aspergillus Positivity in Patients With Tuberculosis-Like Symptoms
Ebong SMA, Kengne VN, Ayong MNA, Foko LPK, Ambono JLN, Ndzana GM, Baïdam MT, Youguitcha O, Abah OZA, Ayangma C, Koro FK.
Positivity rate of Aspergillus spp. in patients with tuberculosis-like symptoms in Yaoundé, Cameroon and antifungal resistance profile.
BMC Infectious Diseases, 9 Mar 2026.
PubMed: https://pubmed.ncbi.nlm.nih.gov/41803790/
This study found Aspergillus positivity in patients initially presenting with tuberculosis-like symptoms.
- Shows again how pulmonary aspergillosis can be confused with TB.
- Also assessed antifungal resistance patterns.
Pulmonary Fungal Infection in Pneumonia
Shokohi R, Mehraban Z, Darvishi F, Fatahinia M, Kiasat N.
Epidemiology and Clinical Features of Pulmonary Fungal Infections in Patients with Pneumonia: A Single-Center Study from Southwestern Iran.
Research Square preprint, 11 Mar 2026.
Preprint: https://www.researchsquare.com/article/rs-1164127
This preprint reports that aspergillosis was a significant component of pulmonary fungal infection among patients with pneumonia.
- Suggests fungal infection may be more common in severe respiratory disease than often recognised.
- As a preprint, findings should be interpreted cautiously until peer reviewed.
Aspergillosis in Complex Clinical Settings
Brain Abscess With Tuberculosis and Aspergillosis
Mirg S, Parihar J, Vibha D, Garg A, Singh G, Singh U, Sharma MC, Tripathi M.
Brain abscess with concurrent infection: tuberculosis and aspergillosis.
Practical Neurology, 13 Mar 2026.
PubMed: https://pubmed.ncbi.nlm.nih.gov/40784749/
This case report describes a rare brain abscess caused by concurrent tuberculosis and aspergillosis.
- Illustrates the complexity of diagnosis when multiple serious infections coexist.
- Highlights the need to keep fungal infection in the differential diagnosis.
Nosocomial Aspergillus calidoustus Infection in CAR-T Cell Therapy
Aubry A, Joris M, Choquet M, Kemp H, Bigot J, Braule B, Lemonnier D, Merlin-Brochart J, Lebon D, Maizel J, Guitard J, Chouaki T.
Nosocomial invasive Aspergillus calidoustus infection in a CAR-T cell-treated patient with concomitant Aspergillus fumigatus respiratory infection.
European Journal of Clinical Microbiology & Infectious Diseases, 12 Mar 2026.
PubMed: https://pubmed.ncbi.nlm.nih.gov/41817606/
This case highlights invasive infection by the rarer species Aspergillus calidoustus in a highly immunocompromised patient.
- Occurred alongside respiratory infection with A. fumigatus.
- Emphasises the diverse Aspergillus species that may affect profoundly immunosuppressed patients.
Additional Papers Mentioning Aspergillosis
These papers mention aspergillosis but are not primarily focused on it.
- Seffar L et al. Beyond Classification: An Antineutrophil Cytoplasmic Antibody-Associated Vasculitis Overlap Case. Cureus, 14 Mar 2026. PMC: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12983185/
- Jandric M et al. Continuous Renal Replacement Therapy for Patients With Sepsis in a Low-Resource Medical Intensive Care Unit (MICU): Incidence, Risk Factors, and Outcomes. Cureus, 14 Mar 2026. PMC: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12979951/
- Koh M et al. Understanding disease burden, challenges in current treatment strategies and call for action for management of severe asthma in Asia: a position statement from Asian respiratory experts. Frontiers in Allergy, 14 Mar 2026. PMC: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12979456/
- Mustafa J et al. Phytochemical profiling of Vitex negundo seeds via UHPLC-QTOF-MS/MS analyses with antimicrobial evaluation and in silico targeting of DNA Gyrase B and Secreted Aspartic Proteinase 2 (SAP2). PLoS One, 13 Mar 2026. PubMed: https://pubmed.ncbi.nlm.nih.gov/41824429/
- Mitchelmore P, Duggan S. Candida in the lung: Fact, fiction, friend or foe? PLoS Pathogens, 10 Mar 2026. PubMed: https://pubmed.ncbi.nlm.nih.gov/41805870/
- Xie Y, Zhang A, Wang Y, Wang R. Community-Acquired Pneumonia in Patients With Diabetes: Narrative Review. JMIR Diabetes, 10 Mar 2026. PubMed: https://pubmed.ncbi.nlm.nih.gov/41805689/
- Long MB et al. Design and rationale of the AIR-NET trial: a randomised, open-label, multifactorial, multicentre, adaptive platform trial using a range of repurposed anti-inflammatory treatments to improve outcomes in patients with bronchiectasis within the EMBARC clinical research network. ERJ Open Research, 9 Mar 2026. PubMed: https://pubmed.ncbi.nlm.nih.gov/41809869/
- Zablonski KG et al. Successful allogeneic stem cell transplant in a patient with a left ventricular assist device: a novel case report. Annals of Hematology, 11 Mar 2026. PubMed: https://pubmed.ncbi.nlm.nih.gov/41807548/
- He D et al. Amphotericin B promotes respiratory viral entry by enhancing late endosomal maturation and fusion via glucocerebrosidase-mediated ceramide remodeling. Nature Communications, 9 Mar 2026. PubMed: https://pubmed.ncbi.nlm.nih.gov/41803143/
Overall Trends
- Rapid molecular diagnostics for Aspergillus detection and resistance testing continue to advance.
- Global awareness of fungal lung disease is improving, especially in patients initially thought to have tuberculosis or bacterial pneumonia.
- Host immunity and microbiome research is expanding understanding of why some patients become vulnerable to Aspergillus disease.
- Alternative treatment approaches, such as inhaled antifungal therapy, are being explored in selected difficult cases.
Latest News posts
News archive