Allergic bronchopulmonary candidiasis: Case report and suggested diagnostic criteria

Lee, Theodore M.; Greenberger, Paul A.; Oh, Soo Hee; Patterson, Roy; Roberts, Mary; Liotta, Janice L.

doi:10.1016/s0091-6749(87)80271-3

Cited by 31 publications

(12 citation statements)

References 15 publications

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“…A similar immunological reaction (with specific IgE and IgG) has been reported less often to other fungi, including CA [2]. Since the present patient did not have asthma symptoms, the diagnosis of allergic bronchopulmonary candidiasis is very unlikely.…”

Section: Discussionsupporting

confidence: 83%

“…Asthma related to immunoglobulin (Ig)E-mediated allergy to CA [1] as well as allergic bronchopulmonary candidiasis has been described [2], but the implication of CA in chronic eosinophilic pneumonia has not been previously reported. In this paper we report on a patient in whom chronic eosinophilic pneumonia developed and levels of specific anti-CA IgE in the serum paralleled the clinical course of the disease.…”

mentioning

confidence: 99%

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Eosinophilic lung disease associated with Candida albicans allergy

Pacheco¹,

Cuevas²,

Carbelo³

et al. 1998

Eur Respir J

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There are few references in the literature about the role of Candida albicans (CA) in eosinophilic lung disease. Asthma related to immunoglobulin (Ig)E-mediated allergy to CA [1] as well as allergic bronchopulmonary candidiasis has been described [2], but the implication of CA in chronic eosinophilic pneumonia has not been previously reported. In this paper we report on a patient in whom chronic eosinophilic pneumonia developed and levels of specific anti-CA IgE in the serum paralleled the clinical course of the disease. Case reportA 43 yr old female was admitted to the hospital reporting symptoms of an intermittent fever of 38°C, nocturnal sweat, chills, dyspnoea, dry cough and malaise, with a weight loss of 4-5 kg during the last 45 days. No improvement was observed despite several courses of amoxicillin and cephalosporin being given. These symptoms were reported by the family because she had had severe mental deficiency since 11 months of age, as a result of severe traumatic head injury. The physical examination revealed a respiratory frequency of 32 breaths·min -1 and crackles in both pulmonary bases. The blood count detected 2,400 eosinophils·mm -3 . The chest radiograph showed a patchy, nonsegmental infiltrate of peripheral distribution in the upper right lobe. This radiological pattern changed its localization at 48 h, inside the same lobe ( fig. 1). There was no previous history of asthma, ingestion of drugs or inhalation of fumes. Although bronchoscopy was indicated, transbronchial biopsy was not possible owing to a lack of collaboration. Bronchoalveolar lavage (BAL) showed a predominant fraction of 40% eosinophils in cytological analysis, with 57% macrophages and 3% lymphocytes. CA was the only fungus isolated from the BAL culture.The serum rheumatoid factor, anti-nuclear antibody, canti-neutrophil cytoplasmic antibody (ANCA) and p-ANCA were all negative. Negative skin-prick test responses were obtained to grass, weed and tree pollens, house dust mite and dog and cat dander. Four examinations of stools for ova of parasites at different times were negative. Total serum IgE and antifungus specific IgE were determined by a fluoroenzyme immunoassay (CAP System; Pharmacia Diagnostics, Uppsala, Sweden) and the results expressed in kU·L -1 . Specific anti-fungus IgG was assessed by an enzyme-linked immunosorbent assay (ELISA) method as described previously [3] and the results were expressed in optical densities (OD). A value at least twice over the negative control (0.6 OD) was considered positive. Serum immunological assays were carried out for seven fungi: Mucor spp., Penicillium spp., Alternaria alternata, Aspergillus fumigatus, Cladosporium herbarum, Trichophyton and CA, and also for Echinococcus granulosus and Toxocara canis. A positive result was only detected for anti-CA IgE: 32.7 kU·L -1 (normal <0.35 kU·L -1 ). The ELISA deter-mination of anti-CA IgG showed a titre of 2.3 OD. Total serum IgE was 1,430 kU·L -1 . Leukocyte histamine release test using peripheral blood was performed as described previou...

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Section: Discussionsupporting

confidence: 83%

mentioning

confidence: 99%

Eosinophilic lung disease associated with Candida albicans allergy

Pacheco¹,

Cuevas²,

Carbelo³

et al. 1998

Eur Respir J

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“…As with allergic bronchopulmonary aspergillosis (ABPA) there is no single diagnostic criteria for allergic bronchopulmonary candidiasis (ABPC), but several criteria have been 2 SEVERE ASTHMA WITH FUNGAL SENSITIZATION used (1, 2) and proposed (3). It is generally suggested that the diagnostic criteria for ABPC and other allergic bronchopulmonary mycoses (ABPM) are analogous to ABPA (1,4), and this assumption will be continued forward in this discussion.…”

Section: Discussionmentioning

confidence: 99%

Severe Asthma with Fungal Sensitization: A Case Report and Review of Literature

2010

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There is a substantial body of evidence supporting an association between asthma severity and fungal exposure and sensitization. Fungal allergens are a recognized risk factor for severe asthma. We describe the case of a 44-year-old asthmatic whose asthma control deteriorated after moving to a new flat with walls covered in mould. Allergic bronchopulmonary aspergillosis was excluded. Although sensitization to Candida was demonstrated by a positive Candida-specific radioallergosorbent test, the patient did not entirely satisfy the criteria for a diagnosis of allergic bronchopulmonary candidiasis. The patient's asthma control improved after engaging in a monthly washing regimen of the walls. This case further demonstrates the association between fungal sensitization and asthma severity. The term severe asthma with fungal sensitization has been recently coined to describe this phenomenon.

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“…However, this seems unlikely because the patient completely met the criteria for ABPC [2]on the first admission without any sign of vasculitis. It has been suggested that the formation of IgE containing immune complexes is involved in the initiation of CSS [8]; however, the issue remains controversial [9].…”

Section: Discussionmentioning

confidence: 99%

“…The patient had a history of steroid-dependent asthma since the age of 58 and had been treated with intramuscular triamcinolon acetate. The patient met the criteria for ABPC proposed by Lee et al [2], namely, history of asthma, fleeting pulmonary infiltrates, elevated serum total IgE (1,400 U/ml), blood eosinophilia (560/mm 3 ), immediate skin reactivity, precipitating antibody and IgE antibody against Candida albicans , repeatedly positive sputum cultures for C. albicans , and lack of evidence indicating involvement of other fungi. Bronchography revealed central bronchiectasis in the right lower bronchus.…”

Section: Case Reportmentioning

confidence: 99%

Allergic Granulomatous Angiitis (Churg-Strauss Syndrome) Associated with Allergic Bronchopulmonary Candidiasis

Matsumoto

Niimi²,

Suzuki³

et al. 2000

Respiration

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We describe a case of Churg-Strauss syndrome (CSS) associated with allergic bronchopulmonary candidiasis (ABPC). A 61-year-old man who had been given a diagnosis of ABPC based on serologic and radiographic findings experienced pain and purpuric rash on the left leg accompanied with motor weakness. The diagnosis of CSS was made from skin, nerve and muscle biopsies. Although immunosuppressant and prednisolone were administered and resulted in transient improvement, candidal pneumonia was suspected to have developed 60 days after the administration and the patient finally died of respiratory failure. To our knowledge, this is the first case of CSS associated with ABPC.

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Allergic bronchopulmonary candidiasis: Case report and suggested diagnostic criteria

Cited by 31 publications

References 15 publications

Eosinophilic lung disease associated with Candida albicans allergy

Eosinophilic lung disease associated with Candida albicans allergy

Severe Asthma with Fungal Sensitization: A Case Report and Review of Literature

Allergic Granulomatous Angiitis (Churg-Strauss Syndrome) Associated with Allergic Bronchopulmonary Candidiasis

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