A rare case of allergic bronchopulmonary mycosis caused byAlternaria alternata

Chowdhary, Anuradha ; Agarwal, Kshitij ; Randhawa, H. S. ; Kathuria, Shallu ; Gaur, S. N. ; Najafzadeh, Mohammad J. ; Roy, P. ; Arora, Naveen ; Khanna, Geetika ; Meis, Jacques F. (2012) A rare case of allergic bronchopulmonary mycosis caused byAlternaria alternata Medical Mycology, 50 (8). pp. 890-896. ISSN 1369-3786

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Official URL: http://doi.org/10.3109/13693786.2012.682320

Related URL: http://dx.doi.org/10.3109/13693786.2012.682320

Abstract

A rare case of allergic bronchopulmonary mycosis (ABPM), caused by Alternaria alternata, is reported in an immunocompetent resident of Delhi. Her complaints included a generalized, urticarial skin rash and occasional pain in the right lower chest. Her differential count showed eosinophils, 22%; absolute eosinophil count (AEC), 2400 cells/μl; and total IgE, 4007 IU/ml. The computerised tomogram (CT) scan of her thorax showed an enhancing lesion with surrounding ground glass haziness in the right lower lobe. Histopathologic examination of the resected lung revealed a necrotizing granulomatous inflammation, parenchymal infiltration by eosinophils, lymphocytes, neutrophils, plasma cells and some exudative bronchiolitis suggestive of ABPM. Observation of KOH wet mounts of repeat sputum and BAL samples demonstrated the presence of septate, brownish hyphae and cultures of these specimens yielded A. alternata (identified by sequencing of the ITS region). Her serum showed a three-fold higher specific IgE to A. alternata antigens than control levels, and the type I cutaneous hypersensitivity response to antigens of A. alternata was strongly positive. She was treated successfully with oral glucocorticoids and itraconazole. To our knowledge, ABPM due to Alternaria alternata has not been reported previously.

Item Type:Article
Source:Copyright of this article belongs to International Society for Human and Animal Mycology.
ID Code:117576
Deposited On:27 Apr 2021 08:14
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