Haemophilus influenzaeによる気道感染軽快後,気管支洗浄液中好酸球数増加が顕性化したABPAの1例 [in Japanese] A Case of Allergic Bronchopulmonary Aspergillosis Demonstrating Marked Eosinophilia in Bronchial Lavage Fluid After Antibiotic Therapy for Bronchitis Due to Haemophilus Influenzae [in Japanese]
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Background. It is not sufficient to clearly identify allergic bronchopulmonary aspergillosis (ABPA) complicated by bacterial infection. Case. A 74-year-old man with a previous history of bronchial asthma and chronic obstructive pulmonary disease (COPD) presented with fever, purulent sputum and dyspnea. He was given a diagnosis of Haemophilus influenzae infection based on a sputum examination, and treated with garenoxacin mesilate hydrate (GRNX). Before antibiotic therapy, a differential leukocyte count from a sputum smear showed 99% neutrophils and 1% eosinophils. After his bacterial infection was resolved, eosinophils in his sputum increased to 20%. We performed bronchoscopy and bronchial lavage to examine the remaining consolidation of the left lower lung. A differential leukocyte count in his bronchial lavage revealed an increase in eosinophils to 50%. Aspergillus fumigatus was cultured in bronchial lavage fluid, and we diagnosed ABPA. Conclusion. When ABPA is complicated by bacterial infection, the clinical characteristics of ABPA are often masked due to an imbalance of Th1/Th2 inflammation (Th1>Th2). Therefore, care must be taken in diagnosing of ABPA complicated by bacterial infection.
- The Journal of the Japan Society for Respiratory Endoscopy
The Journal of the Japan Society for Respiratory Endoscopy 33(6), 491-495, 2011
The Japan Society for Respiratory Endoscopy