交链孢霉引起的变应性支气管肺真菌病：病例报告及文献复习
Allergic bronchopulmonary mycosis due to Alternaria: Case report and review.
作者信息
Singh Bhagteshwar, Denning David W
机构信息
Department of Medicine, North Manchester General Hospital, Manchester, UK.
The National Aspergillosis Centre, University Hospital of South Manchester, Manchester, UK ; The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
出版信息
Med Mycol Case Rep. 2012 Mar 3;1(1):20-3. doi: 10.1016/j.mmcr.2012.02.001. eCollection 2012.
While allergic bronchopulmonary aspergillosis and mycosis are well recognised, no cases have been described related to Alternaria spp. Alternaria is a common sensitising fungus in asthmatics and related to thunderstorm asthma. We report a case of an asthmatic who presented with worsening asthma control, mild eosinophilia on high dose inhaled corticosteroids (800 μg/day), a total IgE of 3800 KIU/L, an Alternaria-specific IgE of 21.3 KUa/L and positive skin prick test, negative specific IgE and skin prick test to Aspergillus fumigatus, Penicillium spp., Cladosporium spp., Trichophyton spp. and a normal CT scan of the thorax. He responded well to a short course of oral prednisolone and then oral itraconazole, given over 17 months but relapsed 1 month after stopping it.
虽然变应性支气管肺曲霉菌病和霉菌病已广为人知，但尚未有与链格孢属相关病例的描述。链格孢是哮喘患者常见的致敏真菌，与雷暴性哮喘有关。我们报告一例哮喘患者，其哮喘控制情况恶化，在高剂量吸入糖皮质激素（800μg/天）治疗下有轻度嗜酸性粒细胞增多，总IgE为3800 KIU/L，链格孢特异性IgE为21.3 KUa/L，皮肤点刺试验阳性，烟曲霉、青霉属、枝孢属、毛癣菌属的特异性IgE和皮肤点刺试验均为阴性，胸部CT扫描正常。他对短期口服泼尼松龙以及随后口服伊曲康唑治疗反应良好，伊曲康唑治疗持续17个月，但停药1个月后复发。
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