A Lung Granuloma Case Possibly Associated with a Working Environment: A Case Report.

Lung granulomas are uncommon in Thailand. The disease typically develops from an occupational environment and is mostly caused by infection. Herein is a case report of a female patient, aged 48, working as a nurse in an Accident and Emergency Department at a hospital. Eighteen years prior to admission the patient was diagnosed with myasthenia gravis and pulmonary tuberculosis. The chest X-ray and CT scans showed a solitary pulmonary nodule in the lower left lung. The patient received an open thoracotomy with a left lobectomy. Granulomatous and nonseptate hyphae were found in the pathology diagnosis. The patient was thus diagnosed as having a lung granuloma. The galactomannan antigen test was positive. The solitary pulmonary nodule-found from the use of a Polymerase Chain Reaction (PCR) test-was an spp. The fungus culture was collected from air samples. The air samples were collected by the impaction technique using a microbial air sampler. Three types of spp. were found as well as spp. and . The spp. was a match for the patient's disease. The patient was diagnosed as having a lung granuloma possibly nodule which was caused by airborne spp. from the occupational environment.