Pattern Of Isolated Fungi From Bronchoalveolar Lavage Among Patients With Bronchial Asthma

Asthma is a heterogeneous disease, usually characterized by chronic airway inflammation and hyper responsiveness. It is defined by the history of respiratory symptoms, such as wheeze, shortness of breath, chest tightness and cough, that vary over time and in intensity, together with variable expiratory airflow limitation. Airflow limitation may later become persistent Making the diagnosis of asthma is based on identifying both a characteristic pattern of respiratory symptoms such as wheezing, shortness of breath (dyspnea), chest tightness or cough, and variable expiratory airflow limitation (Levy ML et al,2006 ) In asthma, lung function may vary between completely normal and severely obstructed in the same patient. Poorly controlled asthma is associated with greater variability in lung function than well-controlled asthma (Graham BL et al,2019 ) A reduced FEV1 may be found with many other lung diseases (or poor spirometric technique), but a reduced ratio of FEV1 to forced vital capacity (FEV1/FVC), compared with the lower limit of normal, indicates expiratory airflow limitation Most patients with asthma can be well-controlled with low doses of anti- inflammatory agents. However, up to 10% of patients with asthma manifest with severe disease, which leads to considerable limitation of activities of daily life and can be fatal .(Moore et al.,2007).

Severe asthma remains a challenge for patients and clinicians, as these patients are not only difficult to treat but also contribute disproportionately to the overall costs of asthma .

The reasons for the variation in severity of asthma from patient to patient are not fully understood. Several environmental factors, such as house dust mite, animal dander from pets, and environmental fungi (especially their continued exposure), are known to worsen asthma control (GINA ,2023).

Fungal diseases are a concern in the medical and public health community because of the increasing number of people with weakened immune systems and the advances in health care practices.

Fungi can be linked to severe asthma in a multitude of ways, including (inhalation of fungal spores; fungal sensitization,and allergic bronchopulmonary aspergillosis (ABPA) a severe degree of fungal sensitization culminating in irreversible bronchopulmonary damage Fungal infections are difficult to diagnose because clinical symptoms, signs, and radiographic manifestations are unspecific. Therefore, a definitive diagnosis requires direct identification of fungi from the site of infection.