Ishiguro Takashi, Takayanagi Noboru, Saito Akemi, Akiyama Kazuo, Wakayama Megumi, Shibuya Kazutoshi, Shimizu Yoshihiko, Sugita Yutaka, Kamei Katsuhiko
Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center.
Nihon Kokyuki Gakkai Zasshi. 2011 Aug;49(8):612-8.
A 53-year-old man who had been suffering from asthma presented to our hospital because of abnormal shadows detected on a chest X-ray film during a routine medical examination. A biopsy specimen of a mucus plug obtained by bronchoscopy showed fungal hyphae, eosinophils, and Charcot-Leyden crystals, with evidence of lung tissue eosinophilia. Schizophyllum commune and Aspergillus fumigatus were isolated from his sputum, bronchial washing specimens and the mucus plug. We detected specific immunoglobulin E anti-Aspergillus fumigatus responses and precipitating antibodies against Schizophyllum commune and Aspergillus fumigatus, which led to the diagnosis of allergic bronchopulmonary mycosis caused by both fungi. We gave him fluticasone/salmeterol and itraconazole; thereafter, his symptoms of cough and sputum production and his radiological findings all improved.
一名53岁的哮喘患者在常规体检时胸部X光片发现异常阴影，遂来我院就诊。经支气管镜获取的黏液栓活检标本显示有真菌菌丝、嗜酸性粒细胞和夏科-莱登结晶，并有肺组织嗜酸性粒细胞浸润的证据。从其痰液、支气管冲洗标本及黏液栓中分离出裂褶菌和烟曲霉。我们检测到针对烟曲霉的特异性免疫球蛋白E反应以及针对裂褶菌和烟曲霉的沉淀抗体，从而诊断为由这两种真菌引起的过敏性支气管肺真菌病。我们给予他氟替卡松/沙美特罗和伊曲康唑治疗；此后，他的咳嗽、咳痰症状及影像学表现均有所改善。
