Severe Asthma with Fungal Sensitization: A Case Report and Review of Literature

Abstract

There is a substantial body of evidence supporting an association between asthma severity and fungal exposure and sensitization. Fungal allergens are a recognized risk factor for severe asthma. We describe the case of a 44-year-old asthmatic whose asthma control deteriorated after moving to a new flat with walls covered in mould. Allergic bronchopulmonary aspergillosis was excluded. Although sensitization to Candida was demonstrated by a positive Candida-specific radioallergosorbent test, the patient did not entirely satisfy the criteria for a diagnosis of allergic bronchopulmonary candidiasis. The patient's asthma control improved after engaging in a monthly washing regimen of the walls. This case further demonstrates the association between fungal sensitization and asthma severity. The term severe asthma with fungal sensitization has been recently coined to describe this phenomenon.

Estimation of the Burden of Serious Human Fungal Infections in Malaysia

“…ABPA [ 15 , 40 ] and SAFS [ 17 , 41 , 42 ] are the most common fungal infections among asthmatics with a notably high prevalence rate. According to a past study, the rates of asthma in adults are 5.51 per 100,000 population, and there are 1.2 million adults with asthma in Malaysia [ 43 ].…”

Two cases of Schizophyllum asthma: Is this a new clinical entity or a precursor of ABPM?

“…In particular, there has been increasing interest in the association between severe asthma and fungal sensitization [1][2][3].…”

“…There has been increasing interest in the relationship between severe asthma and fungal sensitization [1][2][3]. Therefore, testing in adults with asthma that does not respond to first-line treatment should include not only such routine investigation as lung function, sinus CT scanning, sensitization to common inhalant allergens or evaluation of evidence for allergic bronchopulmonary aspergillosis (ABPA) [4], but should also include an evaluation for evidence of colonization with a range of fungi including Alternaria, Candida, and Trichophyton as well as Aspergillus species [5].…”

Control of Airborne and Liquid-borne Fungal and Pet Allergens Using Microwave Irradiation

“…(3) In a recent study, it was demonstrated that a patient's asthma control improved after a monthly washing regimen of the walls contaminated with mold. (12) In another study, it was shown that there was a link between the Alternaria sensitization and allergic rhinitis, which is possibly attributable to the deposition of Alternaria in the upper airways. (13) While extensive data regarding allergen levels in dust samples exist, various levels of such allergens both naturally occurring and/or resuspended from the dust were also found in the air.…”