This week: Aspergillosis after lung cancer, promising new diagnostic markers, and what RSV infections may mean for people with Aspergillus in their lungs.
Three new studies caught our attention this week. They explore why some people develop aspergillosis, how doctors might improve diagnosis, and why finding Aspergillus in a respiratory sample does not always mean the same thing.
1. Lung cancer survivors may face an increased risk of aspergillosis
Zo S et al. — Medical Mycology, 6 November 2026
A large study from South Korea investigated whether people who had survived lung cancer were more likely to develop pulmonary aspergillosis.
Researchers compared 37,005 lung cancer survivors with 111,015 people without lung cancer. They found an increased risk of pulmonary aspergillosis among survivors, particularly following lung cancer surgery.
There are several possible explanations. Surgery and other cancer treatments can change the structure of the lungs, sometimes leaving damaged areas where Aspergillus may be able to establish itself. Some treatments can also temporarily weaken the immune system.
What does this mean for patients?
Most people who have had lung cancer will not necessarily develop aspergillosis. However, persistent or changing respiratory symptoms after cancer treatment deserve careful assessment.
The study reinforces the importance of considering fungal disease when symptoms cannot be fully explained by the original cancer or its treatment.
The researchers used healthcare records to identify aspergillosis, so not every diagnosis could be independently confirmed.
2. Could our immune response help diagnose aspergillosis?
Chantelot L et al. — Medical Mycology, 6 November 2026
Diagnosing aspergillosis can be difficult. Doctors currently use several different tests, including fungal cultures, scans, antibody tests and tests that detect components of the fungus.
However, these tests do not work equally well in every patient.
Researchers investigated a different approach: looking for proteins produced during the body’s immune response to fungal infection.
They examined fluid collected from the lungs during bronchoscopy, including samples from seven patients with invasive pulmonary aspergillosis and four with chronic pulmonary aspergillosis (CPA).
The researchers identified patterns of immune-related proteins that might eventually help distinguish different fungal diseases.
What does this mean for patients?
Instead of looking only for evidence of the fungus, future diagnostic tests might also look at how the body is responding to it.
This could be particularly valuable because people with different immune systems can react very differently to Aspergillus.
The study was small and exploratory. These markers are not yet available as routine diagnostic tests, and much larger studies will be needed to establish whether they are reliable.
3. RSV infections and Aspergillus: infection or colonisation?
Maldonado-Barrueco A et al. — Revista Iberoamericana de Micología, 5 November 2026
Respiratory syncytial virus (RSV) is a common respiratory virus. It can cause serious illness in some adults, particularly those with existing lung disease or weakened immune systems.
Researchers reviewed 11 years of hospital records to investigate patients who had RSV infection and also had Aspergillus detected in respiratory samples.
They found that detecting Aspergillus did not always mean the patient had invasive aspergillosis.
Some patients appeared to have colonisation, where Aspergillus is present in the airways without evidence that it is invading lung tissue. Others were considered to have probable invasive disease.
What does this mean for patients?
A positive Aspergillus culture is an important finding, but it is not a diagnosis on its own.
Doctors need to consider symptoms, CT scans, other laboratory tests and the patient’s underlying health before deciding whether treatment is needed.
This study also highlights why respiratory viruses and fungal disease can be difficult to distinguish, particularly in people who already have damaged lungs.
The study was relatively small, so it cannot establish how frequently RSV leads to invasive aspergillosis.
What connects these three studies?
Although they examine different aspects of aspergillosis, all three illustrate an important principle:
Finding Aspergillus is only part of the story. Understanding the patient is just as important.
The condition of the lungs, the immune system and other illnesses can all influence whether Aspergillus causes disease and how doctors should interpret test results.
This is why diagnosing aspergillosis often requires several different tests and, sometimes, advice from a specialist team.
These research summaries are provided for information and do not replace advice from your own clinical team.
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