Am. J. Respir. Crit. Care Med., Vol 151, No. 2, Feb 1995, 541-543.
A case of acute eosinophilic pneumonia caused by inhalation of Trichosporon terrestre
E Miyazaki, K Sugisaki, T Shigenaga, T Matsumoto, S Kita, Y Inobe and T Tsuda
Department of Internal Medicine, Oita Medical University, Japan.
We present the diagnostically challenging case of an 18-yr-old Japanese
woman who presented with fever, nonproductive cough, and acute respiratory
distress. Her chest radiograph showed diffuse interstitial infiltrates and
bilateral pleural effusions. Eosinophilic pneumonia was diagnosed by
bronchoalveolar lavage and transbronchial lung biopsy. She was treated with
minocycline, and was discharged in 2 wk. However, within 3 h of returning
home, she experienced a recurrence. She showed positive immediate, Arthus,
and delayed-type skin reactions and positive lymphocyte stimulation test to
an antigen derived from Trichosporon terrestre, which was isolated from
dust in her home. In addition, a bronchoprovocation test with the same
antigen caused a nonproductive cough with fever, hypoxemia, and peripheral
eosinophilia. We concluded that T. terrestre was the causal agent of the
acute eosinophilic pneumonia.
