Ito Akihiko, Ishiguro Takashi, Takaku Yotaro, Kagiyama Naho, Kamei Katsuhiko, Takayanagi Noboru
Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Japan.
Division of Respiratory Medicine, School of Medicine, Jikei University, Japan.
Intern Med. 2019 Dec 15;58(24):3569-3572. doi: 10.2169/internalmedicine.2694-19. Epub 2019 Aug 21.
A 42-year-old man with asthma presented in 2007 with chest infiltration and productive cough. Pycnoporus sanguineus and Perenniporia tephropora were repeatedly isolated from sputum and bronchial washing fluids. Because we lacked immunologic evidence, we could not diagnose him with allergic bronchopulmonary mycosis (ABPM) due to these basidiomycetous fungi. At that time, serum-specific IgE and IgG against Schizophyllum commune findings were negative. Inhaled beclomethasone/salmeterol improved his condition. Seven years later, mucous plugs obtained via bronchoscopy at a relapse were compatible with allergic mucin. Because S. commune was isolated from mucous plugs and serum-specific IgG against S. commune turned positive, we diagnosed the patient with ABPM due to S. commune.
一名42岁的哮喘男性患者于2007年出现肺部浸润和咳痰。从痰液和支气管冲洗液中反复分离出血红密孔菌和淡黄卧孔菌。由于缺乏免疫学证据,我们无法诊断他患有由这些担子菌引起的变应性支气管肺真菌病(ABPM)。当时,针对裂褶菌的血清特异性IgE和IgG检测结果为阴性。吸入倍氯米松/沙美特罗改善了他的病情。七年后,在复发时通过支气管镜检查获得的黏液栓与变应性黏蛋白相符。由于从黏液栓中分离出了裂褶菌,且针对裂褶菌的血清特异性IgG转为阳性,我们诊断该患者患有由裂褶菌引起的ABPM。