多種真菌の関与が考えられたアレルギー性気管支肺真菌症の1例  [in Japanese] A Case of Allergic Bronchopulmonary Fungosis Caused by Several Kinds of Fungi.  [in Japanese]

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Abstract

症例は36歳男性. 10歳時に, 気管支端息を発症. 以後, 咳嗽, 喘鳴の増悪と寛解を繰り返した. 昭和60年の胸部検診以来, 繰り返す肺野浸潤影が出現し, 末梢血好酸球増多血清IgE高値, 中心性気管支拡張を認めている. 喀痰培養では Cladosporium が1回検出され, Aspergillus fumigates と Penicillium は頻回に検出されている. 上記3真菌に対する皮内テスト・IgE-RAST・沈降抗体・吸入誘発試験にて, すべて陽性を示した. 以上より A. fumigatus, Penicillium の関与が強く考えられ, 更に Cladosporium の関与の可能性も示唆されたアレルギー性気管支肺真菌症と考えられた.

A 36-year-old man, who had been treated for bronchial asthma since 10 years of age was admitted to Haibara General Hospital because of asthma attack and abnormal chest X-ray shadows. Chest roentgenogram on admission revealed patchy and consolidation shadows in both lung fields. Blood eosinophilia (15%, 1, 155/mm<sup>3</sup>) and elevation of total IgE (7, 800IU/ml) were demonstrated by laboratory examination. Bronchography showed central bronchial ectasia in right B<sup>2</sup>, B<sup>3</sup>, B<sup>6</sup> and left B<sup>1+2</sup>, B<sup>3</sup> and B<sup>6</sup>. Investigations of allergy demonstrated elevated specific IgE levels, positive immediate and late skin reactions, positive “dual” asthmatic responses and positive precipitating antibodies for Aspergillus fumigatus, Penicillium luteum and Cladosporium cladosporioides. Aspergillus fumigatus, Penicillium spp. and Cladosporium spp. were cultured from his sputa.<br>From these clinical symptoms and findings of tests of allergy, all three kinds of fungi, Aspergillus fumigatus, Penicillium and Cladosporium, were considered as causative antigens in this case of allergic bronchopulmonary fungosis.

Journal

  • The Japanese journal of thoracic diseases

    The Japanese journal of thoracic diseases 32(1), 48-54, 1994

    The Japanese Respiratory Society

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