Role of aspergillus species in the pathogenesis of bronchial asthma in paediatrics

ABSTRACT

As understanding of the inflammatory nature of asthma increases, so does our ability to treat asthma. The fine tuned management of asthma requires awareness and the ability to control these other factors. Allergic bronchopulmonary aspergillosis is not just an associated condition that may make asthma worse but it is also a complication of asthma and can be confused with asthma. This study included 25 asthmatic children who suffer sever interactable asthma, their ages ranged from 4-13 years [mean=8.0 +/- 3.5]. They were fourteen males [56%] and eleven females [44%]. All gave [+ve] skin test to aspergillus mix extract. Their total Ig[E] was very high with mean value [505.2] I. U. /ml] which ranged from [44 to 8950 I.U./ ml]; and absolute eosinophllic count mean value was [573 +/- 83/ml]. The atopic ones were 76% and 80% gave positive family history of allergy. Their X-Ray findings showed heavy infilterates and tendancy to central destruction in most of them. While their course of the disease was very progressive and interactable, they only improved on corticosteroid therapy. The specific Ig[E] against Aspergillus fumigatus gave [-ve] results. We found positive cultures for Fungi in Sputum of 25 asthmatics, they were Aspergillus niger [52%], Aspergillus flavus [12%], Aspergillus fumigtus [4%], Candida [36%] and Penicillium [24%] while 20% showed no growth. While the 10 normal controls showed Asp. niger [20%], Candida [40%], Penicillium [10%], and the rest [30%], showed no growth. We conclude that Aspergillosis could affect asthmatic children as well as adults and needs full accurate investigation as well as steroids therapy; when suspicious interactable course noticed in them