Weekly Aspergillosis Update (2–9 February 2026)(Week 5).

This week’s papers cluster around: (1) ICU/viral-pneumonia–associated invasive pulmonary aspergillosis (IPA),
(2) tuberculosis (TB)–chronic pulmonary aspergillosis (CPA) overlap,
(3) diagnostic criteria and emerging detection approaches, and
(4) antifungal drug interaction risk.

Top highlights (quick take)

• CAPA criteria matter: case rates vary substantially depending on which definition is used (AspICU vs ISHAM vs EORTC).
• Viral illness + immune dysfunction = early IPA risk: data add to the “risk stacking” story (including SFTS and broader viral pneumonia).
• TB–CPA remains a major clinical challenge: CPA can be misread as TB relapse; delayed recognition worsens outcomes.
• Safety: rifapentine can markedly reduce voriconazole exposure (important in TB–aspergillosis co-infection).

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1) ICU, Viral Pneumonia & CAPA / IPA

Decoding CAPA: A Comparative Study of Aspicu, Isham, and Eortc Criteria in Critical COVID-19 Patients Requiring Mechanical Ventilation (Preprint)

Taleb C, Lelubre C, Biston P, Piagnerelli M. Preprints.org. 04 Feb 2026. PPR: PPR1150994

• What they did: compared CAPA classification using AspICU, ISHAM and EORTC-style criteria in ventilated COVID-19 patients.
• Key point: CAPA “incidence” changes materially depending on the criteria applied; distributions differed across COVID-19 waves.
• Why it matters: reinforces that audits, research comparisons and ICU protocols must state which definition is used (and why).

Characteristics of T-lymphocyte subsets in patients with severe fever with thrombocytopenia syndrome complicated with invasive pulmonary aspergillosis: a retrospective study

Xu Y, Liu Y, Qian Y, et al. Front Immunol. 09 Feb 2026. PMCID: PMC12876148

• What they found: SFTS patients complicated by IPA showed marked T-cell subset abnormalities and high reported secondary IPA rates.
• Clinical takeaway: another example of viral immune dysregulation predisposing to IPA—analogous to influenza-associated IPA and CAPA.
• Practice relevance: supports heightened fungal vigilance in severe viral syndromes with immune suppression features.

Immunocompromise and early-onset invasive pulmonary aspergillosis in viral pneumonia: a retrospective cohort study

Sun B, Shen J, Dong M, et al. Front Public Health. 02 Feb 2026. PMCID: PMC12852324

• Theme: early IPA can emerge in viral pneumonia in the setting of immunocompromise (not only classic neutropenia).
• Why it matters: backs the “risk stacking” concept—viral lung injury + immune dysfunction (often steroids) can accelerate IPA risk.
• Use: helpful citation for ICU pathways and education materials.

The COVID-19 pandemic: an underlying factor for increased Stenotrophomonas maltophilia infections—A literature review and case study analysis (Review)

Pompilio A, Di Bonaventura G. Front Microbiol. 06 Feb 2026. PMCID: PMC12867275

• What’s relevant to aspergillosis: notes co-detection of Stenotrophomonas maltophilia in COVID-19 patients with invasive aspergillosis.
• Why it matters: underlines polymicrobial complexity in ICU; prompts questions about dysbiosis and pathogen interactions in severe disease.

Pulmonary Cavitation as a Late and Self-Limited Complication of COVID-19 Pneumonia: A Case Report

Osório M, Silveira M. Cureus. 02 Feb 2026. PMCID: PMC12852039

• Clinical reminder: post-COVID cavitation has a broad differential including CAPA and mucormycosis; requires careful exclusion of fungal disease.
• Why it matters: useful for follow-up imaging discussions and MDT differential diagnosis teaching.

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2) TB–CPA overlap & antifungal pharmacology

Clinical features, diagnostic test performance, treatment and outcome of pulmonary tuberculosis patients with chronic pulmonary aspergillosis in China: a retrospective, observational study

Li J, Wu N, Mei C, et al. Front Cell Infect Microbiol. 06 Feb 2026. PMCID: PMC12864492

• Main message: CPA in TB patients is common and can be mistaken for TB relapse; diagnostic delay is consequential.
• Why it matters: strong global relevance—TB remains one of the biggest drivers of CPA burden.
• Use: good reference for post-TB lung disease pathways and CPA awareness materials.

A clinically significant interaction between voriconazole and rifapentine: a case report and review of evidence

Chen T, Chen X, Zhang Q. Front Med (Lausanne). 09 Feb 2026. PMCID: PMC12875967

• What happened: TB–aspergillosis co-infection complicated by rifapentine–voriconazole interaction.
• Key point: rifapentine (a potent enzyme inducer) can substantially reduce voriconazole exposure → risk of treatment failure.
• Why it matters: high-impact safety message; supports use of therapeutic drug monitoring and/or alternative strategies in TB co-treatment.

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3) Diagnostics & detection methods

Combined Biospectroscopy with Multivariate Analysis for the Differential Diagnosis of Leptospirosis Disease: A Pilot Study

Zambrano A, Trilleras J, Arana Rengifo V, et al. ACS Omega. 09 Feb 2026. PMCID: PMC12878783

• Why it’s here: includes a small aspergillosis group among comparator infections.
• What it suggests: biospectroscopy + multivariate modelling may separate infections via biochemical “fingerprints” (early-stage concept).
• Bottom line: promising research direction, but not near-term clinical practice.

Research progress on the current status of respiratory pathogen infections and their detection methods (Review)

Zhu F, Peng M, Chen A, Zhu Q. Front Microbiol. 09 Feb 2026. PMCID: PMC12876234

• Scope: broad overview of respiratory pathogen detection, including invasive and allergic aspergillosis concepts.
• Useful for: background reading for non-specialists and training materials (diagnostic modalities and limitations).

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4) Aspergillus biology, pathology & wider fungal immunology

Characterization of a bZIP Transcription Factor ZipD in Aspergillus flavus

Jeong D, Cho H, Park H. Mycobiology. 06 Feb 2026. PMCID: PMC12865826

• What it is: basic science on gene regulation (ZipD) in Aspergillus flavus.
• Why it matters: contributes to long-term understanding of fungal stress responses and potential future targets.

Mechanistic Insights into Calcium Oxalate Crystals in Aspergillosis of the Maxillary Sinus

Trimukhe A, Bhatt K, Mridha AR, et al. Head Neck Pathol. 02 Feb 2026. PMID: 41627592

• Key message: calcium oxalate crystal deposition is a mechanistic contributor to local inflammation/tissue injury in sinus aspergillosis.
• Clinical relevance: useful for ENT/pathology audiences; supports recognition of crystals as an important clue.

Adjunctive GM-CSF therapy enhances host defense against systemic Candida auris infection in immunosuppressed mice

Mattos E, Das Gupta K, Quintanilla D, et al. Front Immunol. 06 Feb 2026. PMCID: PMC12862068

• Why included: host-directed immunotherapy concepts often discussed alongside invasive aspergillosis.
• Takeaway: GM-CSF improved antifungal host defense in a preclinical model—supporting interest in adjunctive approaches (not clinical guidance).

The therapeutic potential of high-dose inhaled nitric oxide for antimicrobial effects: a narrative review and future directions (Review)

Berra L, Kamenshchikov N, Tal A, et al. Intensive Care Med Exp. 05 Feb 2026. PMCID: PMC12872992

• Scope: experimental antimicrobial strategy, mainly ICU-focused.
• Relevance: future-facing adjunct discussion rather than current aspergillosis practice.

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5) Case reports & broader context (selected)

Case Report: Triple autoimmune overlap: rheumatoid arthritis, systemic lupus erythematosus, and hypereosinophilic asthma with systemic manifestations

Front Immunol. 02 Feb 2026. PMCID: PMC12852425

• Aspergillosis relevance: ABPA considered in complex eosinophilic/asthma phenotypes; reminder that ABPA can present atypically (e.g., without classic bronchiectasis early on).
• Use: supports education on diagnostic nuance in asthma/eosinophilic lung disease.

HIV-associated neurological infections in a Brazilian tertiary care center: clinical-epidemiological features and predictors of in-hospital mortality

Ramos L, Ninomiya D, Sequeira M, et al. Rev Inst Med Trop Sao Paulo. 02 Feb 2026. PMCID: PMC12858172

• Context: opportunistic infection landscape in advanced HIV; useful epidemiological background (limited direct aspergillosis focus).

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Note: This page summarises research and does not replace clinical guidance. If you are a patient and have concerns about symptoms or treatment, contact your clinical team.