Schizophyllum communeによるアレルギー性気管支肺真菌症：他の担子菌菌の陽性培養に特別な関心がある

Allergic Bronchopulmonary Mycosis Caused by Schizophyllum commune: A Special Interest in Positive Culture of Other Basidiomycetes Fungi.

• Akihiko Ito
• Takashi Ishiguro
• Yotaro Takaku
• Naho Kagiyama
• Katsuhiko Kamei
• Noboru Takayanagi

抄録

喘息の 42 歳男性が 2007 年に胸部浸潤と産生性咳嗽を呈した．喀痰と気管支洗浄液からPycnoporus sanguineusとPerenniporia tephroporaが繰り返し分離された．免疫学的証拠がなかったため、これらの担子菌によるアレルギー性気管支肺真菌症（ABPM）とは診断できなかった。その際、白癬菌コミューン所見に対する血清特異的IgE、IgGは陰性であった。ベクロメタゾン/サルメテロールの吸入で病状は改善した。7年後の再発時に気管支鏡検査で得られた粘液栓はアレルギー性ムチンと一致した。粘液栓からS.communeが分離され，S.communeに対する血清特異的IgGが陽性となったため，S.communeによるABPMと診断した。

A 42-year-old man with asthma presented in 2007 with chest infiltration and productive cough. Pycnoporus sanguineus and Perenniporia tephropora were repeatedly isolated from sputum and bronchial washing fluids. Because we lacked immunologic evidence, we could not diagnose him with allergic bronchopulmonary mycosis (ABPM) due to these basidiomycetous fungi. At that time, serum-specific IgE and IgG against Schizophyllum commune findings were negative. Inhaled beclomethasone/salmeterol improved his condition. Seven years later, mucous plugs obtained via bronchoscopy at a relapse were compatible with allergic mucin. Because S. commune was isolated from mucous plugs and serum-specific IgG against S. commune turned positive, we diagnosed the patient with ABPM due to S. commune.