Ishiguro Takashi, Kagiyama Naho, Kojima Ayako, Yamada Masami, Nakamoto Yasuo, Takaku Yotaro, Shimizu Yoshihiko, Kurashima Kazuyoshi, Takayanagi Noboru
Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Japan.
Department of Respiratory Medicine, Tokyo Jikei University, Japan.
Intern Med. 2018 Sep 1;57(17):2553-2557. doi: 10.2169/internalmedicine.0668-17. Epub 2018 Mar 30.
A 63-year-old woman presented to our hospital for cough, sputum, and abnormal shadows on chest X-ray. Schizophyllum commune was isolated from mucous plugs. Positive specific IgE and IgG against the fungi, elevated serum IgE, and mucous plugs with typical histologic findings of allergic bronchopulmonary mycosis (ABPM) led to the diagnosis of ABPM due to S. commune. We initially administered itraconazole unsuccessfully. Changing the antifungal agent to voriconazole resulted in improvement of the symptoms and chest imaging findings. Her ABPM has not relapsed for two years since the cessation of voriconazole, which was administered for one year.
一名63岁女性因咳嗽、咳痰及胸部X光片出现异常阴影前来我院就诊。从黏液栓中分离出裂褶菌。针对该真菌的特异性IgE和IgG阳性、血清IgE升高以及具有变应性支气管肺曲霉菌病(ABPM)典型组织学表现的黏液栓,导致诊断为由裂褶菌引起的ABPM。我们最初给予伊曲康唑治疗,但未成功。将抗真菌药物换为伏立康唑后,症状及胸部影像学表现有所改善。自停用伏立康唑(已使用一年)以来,她的ABPM已两年未复发。