Saito Y, Mikami M, Nakamura S, Hashimoto N, Abe Y, Baba M, Takizawa J, Kawakami M, Kamei K
Department of Pneumology, Tokyo Metropolitan Hiroo General Hospital, Japan.
Nihon Kokyuki Gakkai Zasshi. 1998 May;36(5):498-502.
A 62-year-old man with diabetes mellitus and alcoholic liver cirrhosis was admitted to the hospital because of hemoptysis. Chest X-ray films and computed tomograms showed a dense infiltrative lesion and a healed tuberculous cavity with a possible fungus ball in the upper lobe of the right lung. Bronchoscopy revealed that the hemoptysis originated from the right upper-lobe bronchus. The bleeding stopped after thrombin was applied into the bronchus. Filamentous fungi were seen in lavage fluid from the right upper-lobe bronchus. The fungi were identified as Pseudallescheria boydii, and pulmonary pseudallescheriasis was diagnosed. the patient was treated successfully with miconazole (400 mg/day) for 2 months. Pseudallescheriasis should be taken into account in the differential diagnosis of aspergilloma-like lesions.
一名患有糖尿病和酒精性肝硬化的62岁男性因咯血入院。胸部X光片和计算机断层扫描显示右肺上叶有一个致密的浸润性病变以及一个愈合的结核空洞，空洞内可能有真菌球。支气管镜检查显示咯血源自右上叶支气管。向支气管内注入凝血酶后出血停止。右上叶支气管灌洗液中发现丝状真菌。这些真菌被鉴定为波氏假阿利什霉，诊断为肺假阿利什霉病。患者接受咪康唑（400毫克/天）治疗2个月后成功治愈。在曲霉球样病变的鉴别诊断中应考虑假阿利什霉病。
