To Measure the Incidence of Aspergillus Skin Prick Test Positivity in Patients with Atopic and Nonatopic Symptoms Visiting a Tertiary Care Center

Background: Aspergillus sensitization is increasingly recognized as a key factor in atopic diseases. This study aimed to measure the incidence of Aspergillus skin prick test (SPT) positivity among patients with atopic and nonatopic symptoms visiting a tertiary care center. Materials and Methods: This hospital-based, analytical cross-sectional study was conducted over 18 months at a tertiary care hospital. A total of 190 patients were enrolled using consecutive sampling and categorized into symptomatic (atopic) and asymptomatic (nonatopic) groups. SPTs for various Aspergillus species were performed, along with clinical evaluations. Moreover, absolute eosinophil count (AEC) and serum immunoglobulin E (IgE) levels were analyzed. Statistical comparisons were made using Chi-square tests and binary logistic regression. Results: The incidence of Aspergillus SPT positivity was significantly higher in symptomatic patients (atopic) (55.8%) including expectoration, chest tightness, allergic rhinitis (AR), eczema, wheezing, AEC positivity, and total serum IgE compared to asymptomatic patients (nonatopic) (10.5%). Allergens from Aspergillus species, such as Aspergillus fumigatus, Aspergillus flavus, and Penicillium spp., were more prevalent among symptomatic patients ( P < 0.01). Elevated AEC and serum IgE levels were strongly associated with Aspergillus positivity. Multivariate analysis identified chest tightness, dyspnea, AR, and smoking as significant predictors of Aspergillus sensitization. Furthermore, moderate disease severity was the most common presentation among Aspergillus -positive individuals. Conclusion: The study underscores the significant association of Aspergillus sensitization with atopic symptoms and disease severity. These findings emphasize the importance of early allergen identification and targeted management in atopic patients to mitigate disease progression and improve quality of life.