Hypersensitivity pneumonitis with Paecilomyces as suspected inciting antigen

Masayuki Watanabe; Ryo Okuda; Yuriko Ishida; Shinobu Sagawa; Tatsuya Muraoka; Satoshi Ikeda; Tomoe Sawazumi; Tamiko Takemura; Eri Hagiwara; Takashi Ogura

doi:10.1016/j.rmcr.2024.102013

Hypersensitivity pneumonitis with Paecilomyces as suspected inciting antigen

Respir Med Case Rep. 2024 Mar 21:49:102013. doi: 10.1016/j.rmcr.2024.102013. eCollection 2024.

Authors

Affiliations

¹ Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan.
² Department of Pathology, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan.

Abstract

A 73-year-old man visited our hospital for persistent cough. Chest high-resolution CT (HRCT) showed infiltration shadows in lower lobes and diffuse ground glass opacities in the upper lobes. Blood tests showed elevated white blood cell, C-reactive protein, surfactant protein D, and Krebs von den Lungen-6 levels. After an antigen avoidance test, his HRCT and blood test findings improved; we diagnosed him with hypersensitivity pneumonitis (HP). A culture of the rotting interior walls within his home revealed Paecilomyces, which we believe caused his HP. Given the few patients with Paecilomyces-induced HP, systematic approach was important to identify the inciting antigen.

Keywords: Acute hypersensitivity pneumonitis/ antigen avoidance test; Fungi/ mold/ Paecilomyces/ persistent cough.

Publication types

Case Reports