[A case of severe summer-type hypersensitivity pneumonitis treated with high-dose administration of steroid].
A 40-year-old man who lived in a wooden house built 30 years ago presented with complaints of fever, dry cough and dyspnea. Chest X-ray findings showed interstitial shadows throughout bilateral lung fields. After admission, high-dose administration of 3000 mg of methylprednisolone was performed because of deterioration of chest X-ray shadows and symptoms. In a week, clinical data and symptoms improved. Findings of BAL fluid on admission revealed a relative increase of lymphocytes, neutrophils and mast cells, and pathological findings of transbronchial lung biopsy revealed non-caseous granulation and alveolitis. Precipitating antibodies and indirect fluorescent antibodies against Trichosporon cutaneum and Cryptococcus neoformans had positive reactions and T. cutaneum was isolated and identified from the patient's house. A diagnosis of summer-type hypersensitivity pneumonitis was made according to the criteria advocated by Ando et al. This seemed to be a rare case of summer-type hypersensitivity pneumonitis prolonged after isolation from his normal living environment, successfully treated by high-dose administration of steroid.
Arai
M
M
Chest Institute Department of Medicine, Tokyo Women's Medical College, Japan.
Kawada
H
H
Kaburagi
T
T
Sakai
N
N
Kudou
Y
Y
Kawakami
M
M
Konno
K
K
Takizawa
T
T
D000328:Adult; D000542:Alveolitis, Extrinsic Allergic / Q000188:drug therapy*; D004334:Drug Administration Schedule; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage* / Q000627:therapeutic use; D012621:Seasons
D008775:Methylprednisolone