title: Allergic bronchopulmonary mycosis due to Alternaria: Case report and review.
abstract: While allergic bronchopulmonary aspergillosis and mycosis are well recognised, no cases have been described related to Alternaria spp. Alternaria is a common sensitising fungus in asthmatics and related to thunderstorm asthma. We report a case of an asthmatic who presented with worsening asthma control, mild eosinophilia on high dose inhaled corticosteroids (800 μg/day), a total IgE of 3800 KIU/L, an Alternaria-specific IgE of 21.3 KUa/L and positive skin prick test, negative specific IgE and skin prick test to Aspergillus fumigatus, Penicillium spp., Cladosporium spp., Trichophyton spp. and a normal CT scan of the thorax. He responded well to a short course of oral prednisolone and then oral itraconazole, given over 17 months but relapsed 1 month after stopping it.
authors.affiliation: Department of Medicine, North Manchester General Hospital, Manchester, UK.
authors.forename: Bhagteshwar
authors.initials: B
authors.lastname: Singh
authors.affiliation: The National Aspergillosis Centre, University Hospital of South Manchester, Manchester, UK ; The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
authors.forename: David W
authors.initials: DW
authors.lastname: Denning
keywords: Alternaria; Aspergillosis; IgE; Itraconazole; Mycosis; Skin test