Hagiwara S, Ishii Y, Sugiyama Y, Kitamura S
Department of Pulmonary Medicine, Jichi Medical School, Tochigi, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1995 Sep;33(9):1024-9.
A 33-year-old man was admitted complaining of a fever, dyspnea, and a dry cough almost every night since December of 1992. He had been using an ultrasonic humidifier at home. The chest CT scan and roentgenogram showed bilateral reticulonodular shadows. After admission, the symptoms resolved spontaneously. These findings were suggestive of hypersensitivity pneumonitis. After analysis of fluid obtained by bronchoalveolar lavage and of a specimen obtained by transbronchial biopsy, "humidifier lung" was diagnosed. Ten species of microorganisms were isolated from the water left in the patient's humidifier. On precipitation and complement fixation tests of the patients serum, the results were positive for three of those microorganisms: Flavobacterium multivorum, Yersinia pseudotuberculosis, and Aureobacterium liquefaciens. The titer on the complement fixation test increased immediately after a provocation test. The laboratory results suggest that at least one of these three microorganisms was the causative antigen in this case.
一名33岁男性因自1992年12月以来几乎每晚都发烧、呼吸困难和干咳而入院。他在家中一直使用超声波加湿器。胸部CT扫描和X光片显示双侧网状结节阴影。入院后,症状自行缓解。这些发现提示为过敏性肺炎。在对支气管肺泡灌洗获得的液体和经支气管活检获得的标本进行分析后,诊断为“加湿器肺”。从患者加湿器中残留的水中分离出10种微生物。对患者血清进行沉淀和补体结合试验,结果显示其中三种微生物呈阳性:多食黄杆菌、假结核耶尔森菌和液化金色杆菌。激发试验后补体结合试验的滴度立即升高。实验室结果表明,这三种微生物中至少有一种是该病例的致病抗原。