A case report of allergic bronchopulmonary mycosis caused by Alternaria alternata in colonization of Aspergillus

Min Ju Jo,¹ Yoomi Yeo,¹ Kyueng-Whan Min,² Sung Jun Chung,¹ Tai Sun Park,¹ Hyun Lee,¹ Dong Won Park,¹ Ji-Yong Moon,¹ Jang Won Sohn,¹ Sang-Heon Kim,¹ Ho Joo Yoon,¹ Tae-Hyung Kim¹

¹ Division of Pulmonology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
² Department of Pathology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Seoul, Republic of Korea

Abstract

Background: Allergic bronchopulmonary aspergillosis (ABPA) is a pulmonary disease caused by a complex hypersensitivity reaction to colonization of the airways with various fungi. ABPA caused by Alternaria alternata, other than Aspergillus spp., is named Allergic bronchopulmonary mycosis (ABPM).
Objective: To describe the first case of ABPM caused by Alternaria alternata in East Asia.
Methods: Case report
Results: A 58-year-old female visited our hospital due to an abnormal chest x-ray, following chest computed tomography (CT) revealed consolidation in the left lower lobe. On laboratory finding, eosinophil count and total IgE level were high. The skin prick test and specific IgE for Alternaria alternata were positive. After diagnosis of ABPM, the patient was treated with prednisolone without antifungal agents, and her chest image was much improved.
Conclusion: Aspergillus is most common etiology of allergic pulmonary disease, however, Alternaria should be considered even though positive culture of Aspergillus spp.
Key words: ABPM, Allergic bronchopulmonary, Alternaria alternate, Asthma, Specific IgE