Correlation between Fungal Sensitization in Childhood Persistent Asthma and Disease Severity

Abstract

Background

Fungal sensitization in adults is associated with severe asthma but prevalence and clinical significance of fungal sensitization remains unclear in paediatric population.

Objective

To study association of fungal sensitization with disease severity in children with persistent asthma

Patients and Methods

One hundred children with persistent asthma in age group 7-15 years, symptom duration >2 years and forced expiratory volume in first second >50% of expected were enrolled. Skin prick test (SPT) to 8 fungal antigens and total serum IgE were done. Fungal sensitization was described as positive SPT (wheel diameter more than 3mm larger than the negative control) to any of the fungal antigens and total serum IgE >200ng/ml.

Results

Seventeen patients showed evidence of fungal sensitization, of which, six demonstrated sensitization to multiple fungi. 17.6% patients with fungal sensitization had severe asthma as compared to 2.4% patients without fungal sensitization (p value 0.032). Significant increase in family history of allergic comorbidities was noted among patients with fungal sensitization (47.1% vs 21.7%, p value 0.03). The most common implicated organism in fungal sensitized patients was Aspergillus flavus (47.1%).

Conclusion

The results of this study, a first among Indian children with asthma, suggest that children with fungal sensitization have more severe asthma as compared to children without fungal sensitization.

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