Fujimori Y, Tada S, Kataoka M, Kawaraya M, Ikubo S, Horiba M, Okahara M, Takehara H, Harada M, Tanabe K
Second Department of Internal Medicine, Okayama University Medical School.
Nihon Kokyuki Gakkai Zasshi. 1998 Sep;36(9):781-6.
A 23-year-old man with bronchial asthma presented with fever, cough, and sputum. A chest X-ray examination showed pulmonary infiltrations in the left upper and lower lung fields with central bronchiectasis. Although his temperature came down with antibiotics, pulmonary infiltrations persisted with cough and sputum. Following bronchoscopy and an allergological examination, the patient was given a diagnosis of allergic bronchopulmonary aspergillosis (ABPA) based on Rosenberg's criteria, including peripheral blood eosinophilia, a high serum IgE level, immediate skin reaction to Aspergillus antigen, positive precipitating antibodies, and Aspergillus fumigatus in sputum. The patient was treated with itraconazole instead of corticosteroids. His respiratory symptoms, eosinophilia, and pulmonary infiltration then disappeared, and his IgE serum level gradually decreased. An antifungal agent alone was effective in treating this ABPA patient.
一名23岁的支气管哮喘男性患者出现发热、咳嗽和咳痰症状。胸部X线检查显示左上肺和下肺野有肺部浸润，并伴有中央支气管扩张。尽管使用抗生素后体温下降，但肺部浸润仍伴有咳嗽和咳痰症状持续存在。经过支气管镜检查和变态反应学检查，根据罗森伯格标准，该患者被诊断为变应性支气管肺曲霉病（ABPA），标准包括外周血嗜酸性粒细胞增多、血清IgE水平升高、对曲霉抗原的即刻皮肤反应、阳性沉淀抗体以及痰中烟曲霉。该患者接受了伊曲康唑治疗而非皮质类固醇治疗。随后，他的呼吸道症状、嗜酸性粒细胞增多和肺部浸润消失，血清IgE水平逐渐下降。单独使用抗真菌药物对该ABPA患者有效。
