A case of allergic bronchopulmonary fungosis caused by several kinds of fungi

A 36-year-old man, who had been treated for bronchial asthma since 10 years of age was admitted to Haibara General Hospital because of asthma attack and abnormal chest X-ray shadows. Chest roentgenogram on admission revealed patchy and consolidation shadows in both lung fields. Blood eosinophilia (15%, 1,155/mm3) and elevation of total IgE (7,800 IU/ml) were demonstrated by laboratory examination. Bronchography showed central bronchial ectasia in right B2, B3, B6 and left B1+2, B3 and B6. Investigations of allergy demonstrated elevated specific IgE levels, positive immediate and late skin reactions, positive "dual" asthmatic responses and positive precipitating antibodies for Aspergillus fumigatus, Penicillium luteum and Cladosporium cladosporioides. Aspergillus fumigatus, Penicillium spp. and Cladosporium spp. were cultured from his sputa. From these clinical symptoms and findings of tests of allergy, all three kinds of fungi, Aspergillus fumigatus, Penicillium and Cladosporium, were considered as causative antigens in this case of allergic bronchopulmonary fungosis.