Abstract BACKGROUND: Asthma is a heterogeneous disease, characterized by chronic airway inflammation. Fungal sensitization is associated with a more severe asthma phenotype. Patients often present with poor asthma control, frequent exacerbations, and reduced pulmonary function. It involves a spectrum of disease ranging from simple asthma with fungal sensitization at one end to allergic bronchopulmonary aspergillosis (ABPA) at the more severe end, with variations in the underlying immune response. MATERIALS AND METHODS: This cross-sectional study aimed to determine the prevalence of severe asthma with fungal sensitization (SAFS) and ABPA patients in diagnosed patients of severe bronchial asthma using skin prick test. SPT-positive patients were then subjected to further investigations including total serum immunoglobulin E (IgE), specific IgE against Aspergillus fumigatus , specific IgG against A. fumigatus , chest X-ray, and high-resolution computed tomography (HRCT) of the thorax. RESULTS: A total of 100 severe asthma patients were studied during the study period. The age of the patients ranged between 18 and 58 years, the mean age was 36.00 ± 11.48 years, and the majority were female (52.0%). Breathlessness was the most common symptom, and A. fumigatus sensitization was found in 48% of patients with 95.83% normal chest X-ray and 75% normal HRCT of the thorax. Our study determined the prevalence of SAFS as 22% and of ABPA as 26%. CONCLUSION: Fungal sensitization, particularly to A. fumigatus , is frequently observed in patients with severe bronchial asthma and is associated with a significant occurrence of SAFS and ABPA. Early identification through routine screening can aid in timely diagnosis and targeted management, potentially improving disease control and long-term outcomes in this high-risk population.
Agarwal et al. (Tue,) studied this question.