title: A case of hypersensitivity pneumonitis caused by Humicola fuscoatra.
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.
authors.affiliation: Department of Internal Medicine, Ishikawa Prefectural Central Hospital, Kanazawa University School of Medicine, Kanazawa, Japan. kitatoshi@med3.m.kanazawa-u.ac.jp
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Kita
authors.forename: Kouichi
authors.initials: K
authors.lastname: Nishi
authors.forename: Masaki
authors.initials: M
authors.lastname: Fujimura
authors.forename: Miki
authors.initials: M
authors.lastname: Abo
authors.forename: Takio
authors.initials: T
authors.lastname: Ohka
authors.forename: Masahide
authors.initials: M
authors.lastname: Yasui
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Ogawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Minato
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kurumaya
authors.forename: Shinji
authors.initials: S
authors.lastname: Nakao
mesh_terms: D000542:Alveolitis, Extrinsic Allergic / Q000175:diagnosis / Q000382:microbiology*; D000908:Antibodies, Fungal / Q000032:analysis; D001707:Biopsy, Needle; D001985:Bronchial Provocation Tests; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D003904:Mitosporic Fungi / Q000276:immunology*; D012129:Respiratory Function Tests; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
chemical_list: D000908:Antibodies, Fungal