Allergic fungal conditions generally affect the lungs or sinuses (or both), although in a sense all allergies are generalised. Mucus production and mucosal swelling are the hallmarks of fungal allergies. The prevalence of ABPA and fungal sensitisation among severe asthma patients are likely to be underestimated,
- Occupational lung disease
- Allergic fungal rhinosinusitis
- Allergic bronchopulmonary aspergillosis (ABPA)
- Fungal asthma / SAFS
- Thunderstorm asthma
MECHANISM: The key features of allergic disease are driven by IgE, eosinophils, mast cells, histamine and basophils, which are separate processes from local inflammation seen in some skin and mucosal fungal infections.
SEVERITY: Many allergies are mild and have a minor affect of health but the ones described here have a more severe effect on health. Typically, affected people have multiple allergies.
ATOPY: An allergic tendency (‘atopy’) is often apparent early in life, but the long term natural history of fungal allergy is not well documented. For example many children with asthma ‘grow out of it’, although some develop it again as they get older. Some people have allergic fungal infection that comes and goes in severity, usually for unclear reasons.
CAUSES: Most allergic fungal infection probably has an important genetic component. Some disease states increase the rate of allergies, notably HIV infection and cystic fibrosis but this appears to only be relevant for fungal infection in terms of Aspergillus allergy in cystic fibrosis.
EFFECT OF AGE: Fungal allergy is uncommon in children and peaks in frequency in early adulthood, but may appear at any age. Allergy to some fungi including Malassezia furfur, Alternaria spp., and Penicillium spp. falls in frequency as adults with asthma get older, but remains constant through adulthood to Aspergillus, Trichophyton and Candida (Fukutomi & Taniguchi, 2015).