Matsuzaki Y, Jimi T, Tao Y, Takada S, Miyazaki N
Department of Chest Diseases, National Fukuoka-Higashi Hospital, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1997 Mar;35(3):352-6.
A 67-year-old man was admitted to our hospital because of coughing, a low-grade fever, and abnormal shadows on a chest X-ray film. He had had asthma as a child, but had no asthmatic symptoms on admission. A CT scan showed collapse of the right middle lobe and mucoid impactions in the lingula. Bronchoscopy revealed thick mucus obstructing the right middle-lobe bronchus and the left upper-lobe bronchus. The eosinophil count and the IgE level were abnormally high. Aspergillus fumigatus was detected in his sputum. Tests for immediate skin reaction and precipitating antibody to aspergillus antigen were positive. After treatment with itraconazole he became asymptomatic. Radiographic abnormalities had resolved by 1 month after the start of treatment; a high resolution CT scan obtained after clinical improvement revealed central bronchiectasis. In this patient with allergic bronchopulmonary aspergillosis, a course of itraconazole alone was followed by satisfactory improvement.
一名67岁男性因咳嗽、低热及胸部X线片出现异常阴影而入院。他儿时曾患哮喘，但入院时无哮喘症状。CT扫描显示右中叶肺不张及舌叶黏液嵌塞。支气管镜检查发现浓稠黏液阻塞右中叶支气管和左上叶支气管。嗜酸性粒细胞计数和IgE水平异常升高。痰中检测到烟曲霉。曲霉抗原的即刻皮肤反应试验和沉淀抗体检测均为阳性。使用伊曲康唑治疗后，他症状消失。治疗开始后1个月，影像学异常已消退；临床症状改善后进行的高分辨率CT扫描显示有中央型支气管扩张。在这名变应性支气管肺曲霉病患者中，仅使用一个疗程的伊曲康唑就取得了令人满意的疗效。
