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Allergic bronchopulmonary disease caused by Curvularia lunata and Drechslera hawaiiensis.

机译:由弯孢弯曲菌和夏威夷德氏弯曲菌引起的过敏性支气管肺疾病。

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摘要

Three patients who developed bronchoceles caused by fungi other than Aspergillus sp are described. The first patient presented for investigation of a lesion at the right hilum on chest radiograph and a raised blood eosinophil count. A bronchogram showed complete block of the apical segmental bronchus which at operation was shown to be caused by inspissated material. The second patient was investigated because of a cough productive of plugs of sputum and irregular opacities in both upper zones on chest radiograph and a raised blood eosinophil count. This only cleared after one month on high dose oral prednisone therapy. The third patient with a previous history of left lingular pneumonia and bronchiectasis of the lingular segment of the left upper lobe was investigated three years later for right basal shadowing and a raised blood eosinophil count. The radiograph cleared after one month on high dose oral prednisone treatment. The aetiological agents in these cases were dematiaceous hyphomycetes, fungi ubiquitous in nature, and also agents of plant disease. The causal fungi, Curvularia lunata and Drechslera hawaiiensis, have on a few occasions been reported as causing human disease but in cases quite dissimilar to the three reported here. Septate branching dematiaceous mycelium was consistently seen in the clinical material and isolated from successive sputum specimens from each patient. Immunodiffusion tests from the third patient gave positive results for both fungi. Intraperitoneal inoculations of C lunata and D. hawaiiensis into Swiss white mice proved the pathogenicity of these isolates.
机译:描述了三例由除曲霉菌以外的真菌引起的支气管扩张的患者。第一名患者在胸部X光片上检查了右肺门的病变,并发现嗜酸性粒细胞计数升高。支气管造影显示根尖节段性支气管完全阻塞,这在操作中显示是由于材料不足引起的。对第二例患者进行了检查,原因是咳嗽时产生了痰塞,并且胸部X光片的两个上部区域均出现不规则的混浊,并且嗜酸性粒细胞计数升高。仅在大剂量口服泼尼松治疗一个月后才清除。第三名有左舌肺炎和左上叶舌段支气管扩张病史的患者在三年后接受了检查,检查其右基底阴影和嗜酸性粒细胞计数升高。高剂量口服泼尼松治疗一个月后,X光片清除。在这些情况下,病原体是皮肤上的腐霉菌,自然界中普遍存在的真菌以及植物病原体。因果真菌Curvularia lunata和夏威夷Drechslera hawaiiensis曾有几次据报道引起人类疾病,但在某些情况下与此处报道的三种疾病完全不同。在临床材料中始终可见到分离的分支皮下菌丝体,并从每位患者的连续痰标本中分离出来。来自第三位患者的免疫扩散测试对两种真菌均给出了阳性结果。在瑞士白小鼠中腹腔接种C lunata和夏威夷D. hawaiiensis证明了这些分离株的致病性。

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