Fungal sensitization and its impact on asthma control – A prospective study at allergy clinic

BACKGROUND: Various factors are involved in poorly controlled asthma despite adequate medication and proper inhalation techniques. Mold sensitivity has been associated with increased rates of hospital and intensive care admissions in adults. The fungal sensitization with severe asthma has been coined to describe fungal-sensitized patients with treatment-resistant asthma. The objective of this study was to compare asthma control between fungal- and nonfungal-sensitized (NFS) asthma patients. MATERIALS AND METHODS: Fifty-six cases of asthma were included over a period of 12 months in this prospective study. Data were captured using a proforma. Skin prick test was done as per standard protocol in all patients and a control assessment was done after 6–8 weeks of treatment as per GINA guidelines using Asthma Control Test (ACT) score. Data were analyzed using SPSS version 24.0. RESULTS: Out of 56 enrolled, 32.1% were fungal sensitized and 55.4% to NFS. Seven (12.5%) patients did not have clinically significant reactions. Maximum sensitization was found with Aspergillus spp. but no sensitization with Epicoccum and Cladosporium. Asthma was found to be poorly controlled in 77.8% of the fungal-sensitized group with a mean ACT score of 17.7 ± 1.8 as compared to 6.5% in the NFS group with mean ACT of 21.35 ± 1.6, respectively (P < 0.0001). CONCLUSION: Fungal sensitization was associated with poorly controlled asthma despite adequate medications and education. Early diagnosis and treatment in these patients with antifungals may improve quality of life, reduce exacerbations, and control of the primary disease.