Taniguchi Hirokazu, Abo Hitoshi, Miyazawa Hideki, Noto Hirofumi, Izumi Saburo
Department of Internal Medicine, Toyama Prefectural Central Hospital.
Nihon Kokyuki Gakkai Zasshi. 2005 Feb;43(2):108-11.
A 22-year-old woman has been treated with inhaled corticosteroid for bronchial asthma. Her family moved house to Toyama prefecture in March 2003, and she was enrolled in our hospital. Her chest radiograph on first medical examination showed the right upper lobe infiltration. Bronchoscopy revealed a mucoid impaction at right B2, and Aspergillus fumigatus was cultured from suctioning of pulmonary secretions. Histopathologic findings from transbronchial biopsy revealed eosinophilic pneumonitis but not Aspergillus fumigatus. She was diagnosed allergic bronchopulmonary aspergillosis, and she was started on prednisolone 40 mg/day. The finding of her chest radiograph improved in two weeks. This case suggested that allergic bronchopulmonary aspergillosis was triggered by moving house with exposure of Aspergillus fumigatus. We should give guidance to asthmatics to wear a dust respirator at work in dust-laden environment.
一名22岁女性因支气管哮喘接受吸入性糖皮质激素治疗。2003年3月,她随家人搬到富山县,并入住我院。首次体检时胸部X线片显示右上叶浸润。支气管镜检查发现右B2有黏液嵌塞,从肺分泌物抽吸物中培养出烟曲霉。经支气管活检的组织病理学检查结果显示为嗜酸性肺炎,而非烟曲霉感染。她被诊断为变应性支气管肺曲霉病,并开始服用泼尼松龙40mg/天。两周后其胸部X线片检查结果有所改善。该病例提示,变应性支气管肺曲霉病可能因搬家接触烟曲霉而引发。我们应指导哮喘患者在多尘环境中工作时佩戴防尘口罩。