STUDY OF CANDIDA ALBICANS AND ASPERGILLUS FUMIGATUS AMONG EGYPTIAN POPULATION WITH ALLERGIC BRONCHIAL ASTHMA

Abstract

Candida albicans and Aspergillus fumigatus sensitization was found in 32% of the patients. Aspergillus hypersensitivity was positive in 12% and Candida albicans sensitization was positive in 28% of the patients. Bronchial hypersensitivity to Aspergillus and Candida albicans were confirmed by BPT. The positive predictive value of Aspergillus fumigatus SPT was 83.3% and the positive predictive value of Candida albicans SPT was 78.6%. This concludes that Candida and Aspergillus sensitization by SPT doesn’t necessarily indicates bronchial sensitization to these fungi. The most common airborne was house dust mite with a ratio of 36%. Grass pollens were the second common airborne allergen after Candida albicans with a ratio of 24%. Dog hair was found positive in 20% of patients. The least common was goat hair 1%. 8% of the patients had negative SPT, 15% of the patients were monosensitized while 77% were polysensitized to more than one antigen. There was no statistically significant difference between the non-sensitized patients to Candida and/or Aspergillus and those to sensitized to Candida and/or Aspergillus groups as regard age, gender, duration of asthma, associated allergic conditions, positive family history of allergic conditions, total IgE, FEV1, FVC and FEV1/FVC. There was a statistically significant difference among the two groups as regards number of sensitizers. At the end of our study, fungal sensitization constitutes a high percentage of patients. Adding fungal antigens to routine SPT is essential for early diagnosis and management of fungal sensitization. BPT is gold standard in assessing bronchial hypersensitivity to different antigens including fungi. We recommend its use in case of doubtful diagnosis Further studies are needed to assess the efficacy of subcutaneous immunotherapy and antifungal treatment in cases of asthma with fungal sensitization.