Bryant D H, Rogers P
Thoracic Unit, St. Vincent's Hospital, Sydney, New South Wales, Australia.
Allergy Proc. 1991 Mar-Apr;12(2):89-94. doi: 10.2500/108854191779011855.
Farmer's lung is rare in Australia whereas allergic alveolitis due to domestic fungal exposure ("domestic allergic alveolitis") is common. However there has been no systematic analysis of the fungi responsible for domestic allergic alveolitis in Australia. The aim of this study was to determine the sources and types of fungi that cause this type of alveolitis in Australia. Twelve subjects with recently diagnosed, biopsy proved, alveolitis thought on clinical grounds to be due to domestic fungal exposure were studied. The houses of all subjects were inspected, and fungal samples were taken. All lived in substandard inner city dwellings. Extensive wood decay was found in 10/12 while 4/12 also had obvious fungal growth on damp walls. Twelve fungal species were identified including Serpula lacrymans (8/12), Paecilomyces variottii (6/12), Aspergillus fumigatus (5/12), and Leucogyrophana pinastri (2/12). No single fungal group predominated. Nine of 12 patients showed positive precipitin results to one or more of the isolated fungi. Inhalation tests were done with extracts of Serpula lacrymans, Geotrichum candidum, and Aspergillus fumigatus in six of the patients and a positive late response to one or more of the fungi was observed in five of these. Relocation of the patients to a new dwelling resulted in improvement in each case.
农民肺在澳大利亚较为罕见，而因接触家庭环境中的真菌导致的过敏性肺泡炎（“家庭性过敏性肺泡炎”）则较为常见。然而，目前尚未对澳大利亚导致家庭性过敏性肺泡炎的真菌进行系统分析。本研究的目的是确定在澳大利亚引起这类肺泡炎的真菌来源和类型。对12名近期诊断为活检证实的肺泡炎患者进行了研究，临床认为其病因是接触家庭环境中的真菌。对所有受试者的房屋进行了检查，并采集了真菌样本。所有患者均居住在市中心不合标准的住宅中。12例中有10例发现广泛的木材腐烂，12例中有4例在潮湿墙壁上有明显的真菌生长。鉴定出12种真菌，包括泪管菌（12例中的8例）、拟青霉（12例中的6例）、烟曲霉（12例中的5例）和松白卧孔菌（12例中的2例）。没有单一真菌类群占主导。12例患者中有9例对一种或多种分离出的真菌沉淀素检测呈阳性。对6例患者用泪管菌、白地霉和烟曲霉提取物进行吸入试验，其中5例对一种或多种真菌出现阳性迟发反应。将患者转移到新住所后，每例病情均有改善。
