The J of Community Health Management. 2015; 02(3) ; 104-110 104 Original Article CLINICO-IMMUNOLOGICAL AND MICROBIOLOGICAL STUDY OF BRONCHIAL ASTHMA WITH SPECIAL REFERENCE TO ASPERGILLUS J K Mishra, 1 Usha Singh, 2 Ragini Tilak, 3 S K Meena, 1 G Singh 4 1 Department of TB and Respiratory Diseases, 2 Department of Pathology, 3 Department of Microbiology, 4 Division of Biostatistics Institute of Medical Sciences, Banaras Hindu University, Varanasi (India) Address for Correspondence: Prof. J. K. Mishra, Department of TB & Respiratory Diseases, Institute of Medical Sciences, Banaras Hindu University, Varanasi – 221005 (India) E-mail: jkmishra.imsbhu@gmail.com ABSTRACT Background: Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity reaction to Aspergillus mycelia that colonize in the bronchi. The susceptibility of asthmatic patients to develop ABPA is not fully understood. Aim: To evaluate the clinical, immunological, microbiological and radiological features of Aspergillus infection in patients with asthma. Methodology: 50 Patients with Bronchial Asthma as cases and 20 age and sex matched non asthmatic individuals as controls were selected for study from OPD of Department of TB and Respiratory Diseases, University Hospital, Institute of Medical Sciences, Banaras Hindu University, Varanasi during the period of January 2013 to July 2014. Various clinical, immunological, microbiological and radiological features of aspergillus infection in patients were recorded. The observed data was analyzed and intergroup comparisons were done. Result: In patients of bronchial asthma with positive aspergillus the percentage of presence of breathlessness, cough, family history, allergic rhinitis, history of ATT intake, AEC, IgE, IgG, BAL and CECT Thorax lied between 62.5% to 100% and most of these showed statistically significant difference. Conclusion The development of ABPA is probably the combination of many genetic susceptibility factors. Understanding of the genetic risks and immuno- pathogenesis of ABPA will lead to early diagnosis and improved treatment of ABPA. Keywords: Aspergillus, Aspergillosis, Bronchopulmonary Aspergillosis (ABPA), Bronchial Asthma Introduction Aspergillus species are ubiquitous spore-forming fungi present in the environment that causes a variety of clinical syndromes, ranging from saprophytic colonization to extensive life threatening invasion with a multitude of intermediary conditions. There are about 180 species of Aspergillus. Allergic bronchopulmonary aspergillosis is the best- known allergic manifestation of Aspergillus- related hypersensitivity pulmonary disorders. ABPA is a hypersensitivity lung disease due to bronchial colonization by Aspergillus fumigatus that occurs in susceptible patients with asthma and cystic fibrosis (CF). ABPA was first reported by Hinson 1 and his colleagues and all major work on ABPA was done by Pepys et al and McCarthy. 2-3 ABPA is a hypersensitivity reaction to Aspergillus mycelia that colonize in the bronchi. Asthma and cystic fibrosis are the common illnesses associated with ABPA. 4-5