Kishimoto N, Mouri M, Sakurai S, Nanbu Y, Ohya N
Department of Internal Medicine, Kanazawa Medical University, Ishikawa, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1993 Feb;31(2):275-9.
A 58-year-old female was admitted to our hospital because of fever and dyspnea on exertion. She has been working in the factory making Pholiota nameko for 8 years. Her chest X-ray revealed diffuse linear and fine nodular shadows in both lower lung fields. Hypoxemia was seen on blood gas analysis. Bronchoalveolar lavage (BAL) and transbronchial lung biopsy (TBLB) were performed. Differential cell count of the BAL fluid showed lymphocytosis and CD4/8 was decreased. TBLB specimens revealed bronchioloalveolitis. Precipitins against Trichosporon cutaneum were detected by Ouchterlony method. These findings are compatible with hypersensitivity pneumonitis, and Trichosporon cutaneum may have been causative antigen in this case. Trichosporon cutaneum is often detected in the Japanese summer-type hypersensitivity pneumonitis. This case suggests that Trichosporon cutaneum is one cause of hypersensitivity pneumonitis in workers at factories making Pholiota nameko.
一名58岁女性因发热和劳力性呼吸困难入院。她在生产滑子菇的工厂工作了8年。胸部X线显示双下肺野弥漫性线状和细小结节状阴影。血气分析显示低氧血症。进行了支气管肺泡灌洗（BAL）和经支气管肺活检（TBLB）。BAL液的细胞分类计数显示淋巴细胞增多，CD4/8降低。TBLB标本显示细支气管肺泡炎。用免疫双扩散法检测到针对皮状丝孢酵母的沉淀素。这些发现符合过敏性肺炎，在该病例中皮状丝孢酵母可能是致病抗原。皮状丝孢酵母在日本夏季型过敏性肺炎中常被检测到。该病例表明皮状丝孢酵母是生产滑子菇工厂工人过敏性肺炎的一个病因。
