A case of hypersensitivity pneumonitis caused by Humicola fuscoatra |
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Authors: | Kita Toshiyuki Nishi Kouichi Fujimura Masaki Abo Miki Ohka Takio Yasui Masahide Ogawa Haruhiko Minato Hiroshi Kurumaya Hiroshi Nakao Shinji |
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Affiliation: | Department of Internal Medicine, Ishikawa Prefectural Central Hospital, Kanazawa University School of Medicine, Kanazawa, Japan. kitatoshi@med3.m.kanazawa-u.ac.jp |
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Abstract: | A 51-year-old housewife with hypersensitivity pneumonitis caused by Humicola fuscoatra is reported. The diagnosis was made by an inhalation challenge with H. fuscoatra antigen. She was admitted for diagnosis and treatment of a fever and productive cough. Auscultation of her lungs revealed inspiratory fine crackles. Her chest CT showed diffuse miliary nodules in a centri-lobular distribution with patchy ground glass opacities. Findings of transbronchial lung biopsy and BAL fluid were compatible with a hypersensitivity pneumonitis. Her symptoms worsened on returning home, which suggested the existence of some aetiological agent in the subject's house. H. fuscoatra, Penicillium decumbens and Aspergillus versicolor were isolated from a number of rooms. High titres of serum anti H. fuscoatra, P. decumbens and A. versicolor were detected. Inhalation challenge tests with both P. decumbens and A. versicolor antigen were negative, in contrast to that with H. fuscoatra which was positive. Based on these results, we advised the patient to cleanse her entire house. Since cleaning, her symptoms have not worsened upon returning home. This is the first report of hypersensitivity pneumonitis caused by H. fuscoatra antigen. |
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Keywords: | Humicola fuscoatra hypersensitivity pneumonitis inhalation challenge test returning-home provocation test |
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