title: [A case of chronic pulmonary paracoccidioidomycosis].
abstract: In a 43-year-old Japanese Brazilian who came to Japan in 2001, since subjective symptoms such as cough, sputum, and dyspnea on exertion had become severe, he was referred to our hospital because of suspicion of pulmonary tuberculosis in chest radiography and CT findings. A chest radiograph of initial examination showed interstitial shadows in both lungs with nodular, infiltrative or cavitary changes. No Mycobacterium tuberculosis was found. The mycetocyte with multipolar budding resembling the steerage of a ship, which was characteristic of Paracoccidioides was observed in sputum and transbronchial lung biopsy specimens. We cultured a fungus to show dimorphism of temperature dependency, and a diagnosis of chronic lung paracoccidioidomycosis was arrived at. By administration of ITCZ 200 mg/day, the chest radiography findings and clinical manifestations were improved. This case seems to be worthy of reporting in Japan since the affected site or organ was limited to the two lungs with multiple cavitary lesions and fibrotic changes on radiographic examination, and final diagnosis was made by cytology of sputum and pathology of TBLB specimens.
authors.affiliation: Division of Internal Medicine, Iwamizawa Rosai Hospital 4 jo-east 16 5 Iwamizawa, Hokkaido, 068-0004, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Igarashi
authors.forename: Tatsuhiko
authors.initials: T
authors.lastname: Kurose
authors.forename: Kouichi
authors.initials: K
authors.lastname: Itabashi
authors.forename: Ikuo
authors.initials: I
authors.lastname: Nakano
authors.forename: Kenzo
authors.initials: K
authors.lastname: Okamoto
authors.forename: Ayako
authors.initials: A
authors.lastname: Sano
authors.forename: Kiyonobu
authors.initials: K
authors.lastname: Kimura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kaji
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use; D001938:Brazil; D004641:Emigration and Immigration; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use; D008172:Lung Diseases, Fungal / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010229:Paracoccidioidomycosis / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology
chemical_list: D000935:Antifungal Agents; D017964:Itraconazole