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Article in Japanese
A case of asthma-like symptoms caused by stent colonization with Scedosporium apiospermum in the left main bronchus
Takashi Ohe Taizou Hirano Akira Koarai Tomohiro Ichikawa Teruyuki Sato Masakazu Ichinose
Department of Respiratory Medicine, Tohoku University Graduate School of Medicine
As with the Aspergillus spp., Scedosporium spp. can cause various types of pulmonary disease such as invasive mycosis, non-invasive mycosis (colonization and scedosporiosis), and allergic diseases. However, no case of colonization by Scedosporium spp. in the tracheobronchus has been reported. A 76-year-old Japanese woman who had undergone an airway stent insertion for stenosis of the left main bronchus caused by bronchial tuberculosis suffered from recurrent dyspnea and wheeze. She was diagnosed with an exacerbation of asthma and treated with prednisolone during each exacerbation. However, her symptoms worsened and she was referred to our hospital. On admission, chest computed tomography revealed a tumor-like shadow attached to the airway stent in the left main bronchus. We performed a bronchoscopy for evaluation purposes and found a white necrotic substance attached to the stent. Culture of the necrotic substance reduced the Scedosporium apiospermum, and we finally diagnosed her with stent colonization by Scedosporium apiospermum in the left main bronchus. Treatment with voriconazole diminished the stent infection and improved her symptoms. Although a rare case, infection caused by Scedosporium apiospermum should be considered when a patient with structural abnormalities in the lungs involving an airway stent who is in an immunocompromised condition presents with recurrent dyspnea and wheezing.
Scedosporium spp. Airway stent Asthma
Received 2 Dec 2017 / Accepted 8 Feb 2018
AJRS, 7(3): 187-191, 2018