健常成人に発症し好酸球増多症を示した慢性肺ノカルジア症の1例

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  • Chronic Pulmonary Nocardiosis with Eosinophilia in an Immunocompetent Host.

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A 75-year-old man who worked at a horse racing track, had an abnormal shadow on a chest radiography. He had a history of dilated cardiomyopathy and mitral regurgitation but had not had any respiratory or systemic symptoms for two years.<br>Chest radiographs and CT scans showed slowly increasing consolidation with internal areas of low attenuation, and without cavity formation, at the left S8. The erythrocyte sedimentation rate, C-reactive protein level, WBC count, percentage of eosinophils, and IgE level were 35mm/hr, negative, 8400, 17%, and 3628IU/ml, respectively. Eosinophils were found in samples of sputum. His immunological status was normal.<br>Transbronchial lung biopsy yielded necrotic tissue, along with gram-positive and irregular acid-fast branching filaments that grew in culture. The microorgansim was identified as Nocardia asteroides.<br>Occupational inhalation of soil may have caused his disesase.

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