Okazaki Ryota, Arita Shino, Hoshio Hinako, Uetani Naoki, Inui Genki, Ishikawa Hiroki, Nonaka Takafumi, Kohno Hiroki, Funaki Yoshihiro, Harada Tomoya, Morita Masato, Watanabe Akira, Yamasaki Akira
Division of Respiratory Medicine and Rheumatology, Faculty of Medicine, Tottori University, Tottori, Japan.
Medical Mycology Research Center, Chiba University, Chiba, Japan.
Respir Med Case Rep. 2024 Aug 22;51:102092. doi: 10.1016/j.rmcr.2024.102092. eCollection 2024.
A 61-year-old woman, hospitalized for a persistent cough and dyspnea, had no history of bronchial asthma, but was undergoing chemotherapy for methotrexate-related lymphoproliferative disorder due to rheumatoid arthritis. Her peripheral blood eosinophil count was significantly increased, and chest CT revealed left lower lobe atelectasis and high-attenuation mucus. Bronchoscopy revealed mucous plugs and pathological examination revealed numerous eosinophils and filamentous fungi. Allergic bronchopulmonary mycosis (ABPM) caused by was diagnosed using culture and genetic analyses. Treatment with corticosteroids and antifungal drugs led to improvement. ABPM caused by is extremely rare, emphasizing the importance of species identification.
一名61岁女性因持续咳嗽和呼吸困难入院，既往无支气管哮喘病史，但因类风湿关节炎正在接受甲氨蝶呤相关淋巴增殖性疾病的化疗。她的外周血嗜酸性粒细胞计数显著增加，胸部CT显示左下叶肺不张和高密度黏液。支气管镜检查发现黏液栓，病理检查发现大量嗜酸性粒细胞和丝状真菌。通过培养和基因分析诊断为由 引起的变应性支气管肺真菌病（ABPM）。使用皮质类固醇和抗真菌药物治疗后病情好转。由 引起的ABPM极为罕见，强调了菌种鉴定的重要性。
