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Allergic Bronchopulmonary Mycosis due to Exposure to Eurotium herbariorum after the Great East Japan Earthquake

Published online by Cambridge University Press:  15 August 2017

Chiyako Oshikata ,
Maiko Watanabe ,
Akemi Saito ,
Masatsugu Ishida ,
Seiichi Kobayashi ,
Rumi Konuma ,
Yoichi Kamata ,
Jun Terajima ,
Junichi Cho  and
Masaru Yanai
...Show all authors
Chiyako Oshikata
Affiliation:
National Hospital Organization Saitama National Hospital, Department of Respirology, Wako, Saitama, Japan National Hospital Organization Sagamihara National Hospital, Department of Allergy and Respirology, Sagamihara, Kanagawa, Japan
Maiko Watanabe
Affiliation:
Division of Microbiology, National Institute of Health Science, Setagaya-ku, Tokyo, Japan
Akemi Saito
Affiliation:
National Hospital Organization, Sagamihara National Hospital, Clinical Research Center for Allergy and Rheumatology, Sagamihara, Kanagawa, Japan
Masatsugu Ishida
Affiliation:
Department of Respiratory Medicine, Japanese Red Cross Ishinomaki Hospital, Ishinomaki, Miyagi, Japan
Seiichi Kobayashi
Affiliation:
Department of Respiratory Medicine, Japanese Red Cross Ishinomaki Hospital, Ishinomaki, Miyagi, Japan
Rumi Konuma
Affiliation:
Tokyo Metropolitan Industrial Technology Research Institute, Koto-ku, Tokyo, Japan
Yoichi Kamata
Affiliation:
Faculty of Agriculture, Iwate University, Morioka, Iwate, Japan
Jun Terajima
Affiliation:
Division of Microbiology, National Institute of Health Science, Setagaya-ku, Tokyo, Japan
Junichi Cho
Affiliation:
Ishinomaki City Hospital, Kaisei Temporary Clinic, Ishinomaki, Miyagi, Japan
Masaru Yanai
Affiliation:
Department of Respiratory Medicine, Japanese Red Cross Ishinomaki Hospital, Ishinomaki, Miyagi, Japan
Naomi Tsurikisawa*
Affiliation:
National Hospital Organization Saitama National Hospital, Department of Respirology, Wako, Saitama, Japan National Hospital Organization Sagamihara National Hospital, Department of Allergy and Respirology, Sagamihara, Kanagawa, Japan
*
Correspondence: Naomi Tsurikisawa, MD National Hospital Organization Saitama National Hospital Department of Respirology 2-1 Suwa, Wako, Saitama, 351-0102, Japan E-mail: [email protected]
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Abstract

Background

Indoor mold levels typically increase after natural disasters, flooding, and water damage. Eurotium herbariorum is the sexual stage of Aspergillus glaucus.

Case Presentation

A 66-year-old, Japanese male, ex-smoker had been diagnosed with bronchial asthma when he was five years old; he achieved remission at the age of 13 years. He was displaced from his home during the Great East Japan Earthquake on March 11, 2011 and moved to temporary housing in Miyagi Prefecture in June 2011. He experienced the first episode of chest tightness, coughing, and wheezing in February 2012, when he again was diagnosed as having bronchial asthma. Mycofloral surveillance detected high counts of Eurotium in the air of his bedroom, kitchen, and living room, with a maximal fungal count of 163,200 colony-forming units per cubic meter (CFU/m3). Although Cladosporium and Penicillium typically predominate in the indoor air of residential dwellings, only low levels of these organisms were present in the patient’s home. Morphologic identification confirmed the isolates as E. herbariorum. The patient had positive reactions to E. herbariorum in skin prick testing and the presence of antigen-specific precipitating antibodies to E. herbariorum. Computed tomography of the chest in August 2013 revealed central bronchiectasis and bronchial wall thickening. The patient experienced late reactions after provocation testing with E. herbariorum.

Conclusion

This report presents the rare case of a patient who developed allergic bronchopulmonary mycosis (ABPM) due to exposure to E. herbariorum during temporary housing after the Great East Japan Earthquake.

OshikataC, WatanabeM, SaitoA, IshidaM, KobayashiS, KonumaR, KamataY, TerajimaJ, ChoJ, YanaiM, TsurikisawaN. Allergic Bronchopulmonary Mycosis due to Exposure to Eurotium herbariorum after the Great East Japan Earthquake. Prehosp Disaster Med. 2017;32(6):688–690.

Keywords

allergic bronchopulmonary mycosisaspergillus fumigatusaspergillus glaucuseurotium herbariorumGreat East Japan Earthquake
Type
Case Reports
Information
Prehospital and Disaster Medicine , Volume 32 , Issue 6 , December 2017 , pp. 688 - 690
Copyright
© World Association for Disaster and Emergency Medicine 2017 

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Footnotes

Conflicts of interest/funding: None of the authors has any potential financial conflicts of interest. This study was supported by a Health Labour Sciences Research Grant from the Ministry of Health, Labour, and Welfare of Japan.

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