Wöckel W, Wernert N, Graf N
Dtsch Med Wochenschr. 1987 Jun 26;112(26):1043-7. doi: 10.1055/s-2008-1068191.
A 17-year-old girl developed fever, cough and hemoptysis, as well as bouts of septic fever, dyspnea on exertion, cyanosis and weight loss. Opacification in the left lower lung was a persistent feature. Complement-fixation reaction to Aspergillus fumigatus was 1:80, and there were four precipitation lines against this fungus on immunoelectrophoresis. Aspergilli were also demonstrated in sputum and bronchial aspirate. Because the patient's condition deteriorated an atypical lingula resection was performed and cortisone treatment begun postoperatively. Subsequently all abnormal findings disappeared and the patient was cured. Two subsequent exposures to Aspergillum on the parental farm produced high fever, cough, dyspnea and thoracic pain. Histological examination of the lingular specimen revealed bronchocentric granulomatosis. In this case it was the rarely occurring morphological manifestation of an allergic bronchopulmonary aspergillosis without bronchial asthma.