Hypersensitivity Pneumonitis and Bronchial Asthma Attacks Caused by Environmental Fungi

• Published in: Allergology international Vol. 57; no. 3; pp. 277 - 280
• Main Authors: Katayama, Nobuyuki, Fujimura, Masaki, Yasui, Masahide, Ogawa, Haruhiko, Nakao, Shinji
• Format: Journal Article
• Language: English
• Published: England Elsevier B.V 2008; Elsevier
• Subjects: Aged; Air Pollution, Indoor - adverse effects; Alveolitis, Extrinsic Allergic - diagnosis; Alveolitis, Extrinsic Allergic - microbiology; Aspergillus fumigatus; Asthma - diagnosis; Asthma - microbiology; Bjerkandera adusta; bronchial asthma; Bronchial Provocation Tests; Coriolaceae - immunology; Environmental Exposure; home environment provocation test; Housing; Humans; hypersensitivity pneumonitis; inhalation challenge test; Male; Bjerkandera adusta; bronchial asthma; home environment provocation test; hypersensitivity pneumonitis; inhalation challenge test
• ISSN: 1323-8930; 1440-1592
• DOI: 10.2332/allergolint.C-07-56

We report a case of hypersensitivity pneumonitis and asthma attacks caused by environmental fungi in a 75-year-old man. The diagnosis was established by inhalation challenge with Bjerkandera adusta and Aspergillus fumigatus. The patient was admitted for treatment of fever, wheezing, and dyspnea. Chest computed tomography showed small nodular shadows with diffuse, partially patchy, ground-glass opacities. The findings of bronchoalveolar lavage fluid were compatible with hypersensitivity pneumonitis. His symptoms and objective findings, including chest radiographs, worsened after returning home, suggesting the existence of causative antigens in his house. B. adusta and A. fumigatus were isolated from the living room and bedroom. Based on the results of antigen inhalation bronchoprovocation test, he was given a diagnosis of hypersensitivity pneumonitis caused by B. adusta and bronchial asthma attacks caused by B. adusta and A. fumigatus. After cleaning the entire house, the patient has had no recurrence of the symptoms on returning home.