Chonnam Med J.  1999 Jun;35(2):295-301.

A Case of Summer-Type Hypersensitivity Pneumonitis

Affiliations
  • 1Department of Internal Medicine, Chonnam University Medical School, Kwangju, Korea.
  • 2Department of Anatomic Pathology, Kwangju Christian Hospital, Kwangju, Korea.

Abstract

Hypersensitivity pneumonitis is an immunologically induced inflammation of the lung parenchyma resulting from the repeated inhalation of a variety of etiologic agents including organic dusts and simple chemicals. There are numerous causes of hypersensivity pneumonitis, summer-type hypersentivity pneumonitis whose major causative agent is Trichosporon cutaneum is the most prevalent type in Japan. We report a case of summer-type hypersensivity pneumonitis confirmed by the assay of anti-Trichosporon antibodies.A thirty one-year old healthy, non-smoking female developed exertional dyspenea, dry cough, low grade fever and chills in August 1995. She was admitted to Chonnam University Hospital in November 1995, and on examination she had bibasilar crackles, and PaO2 of 61.9 mmHg. Pulmonay function testing showed 41%, 33% and 53% of predicted FVC, FEV1 and carbon monoxide diffusing capacity, A chest radiography and high resolution computerized tomography(HRCT) showed diffuse ground glass appearance. Transbronchial lung biopsy(TBLB) revealed granuloma formation. She was improved slowly after the anti-tuberculous medication under the impression of pulmonary tuberculosis. But her symptoms recurred in August 1996 and in July 1997. Because of the clinical history and findings consistent with summer-type hypersensitivity pneumonitis. We examined the patient's serum anti-Trichosporon antibodies. Indirect fluorescent antibody(IFA) was positive at the titer of 1:64 and 1:128 to both standard strains of Trichosporon cutaneum serotypeI(T. mucoides) and serotype II(T. asahii). Precipiting antibodies to T. asahii were also positive. Her symptoms improved after PRD medication and moving to the other house.

Keyword

summer-type hypersensitivity pneumonitis; Trichosporon cutaneum
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