Strelling et al.,(3) conducted in the UK in 1966 |
1 |
Sisters who played long hours in a barn during the months preceding the disease, thus being exposed to natural and artificial manure; linseed oil; cattle cake; and grain. |
Not stated |
None |
Dyspnea, fever, and cough |
Chest X-ray showed bilateral patchy infiltrates, more in the middle lobes |
Sputum, negative for fungus |
Lung needle biopsy, no organism identified |
Not stated |
Not stated |
Death (in both cases); positive staining for fungus was observed at autopsy |
2 |
Dyspnea and fever |
Chest X-ray showed bilateral homogeneous infiltrates |
Not stated |
Meeker et al.,(44. Meeker DP, Gephardt GN, Cordasco EM Jr, Wiedemann HP. Hypersensitivity pneumonitis versus invasive pulmonary aspergillosis: two cases with unusual pathologic findings and review of the literature. Am Rev Respir Dis. 1991;143(2):431-6. http://dx.doi.org/10.1164/ajrccm/143.2.431 http://dx.doi.org/10.1164/ajrccm/143.2.4...
) conducted in the USA in 1991 |
3 |
Exposure to old damp hay two weeks prior to presentation |
Not stated |
None |
Low-grade fever, chills, and dry cough |
Chest X-ray showed diffuse nodular and interstitial infiltrates |
Sputum and BAL, negative for fungus; lung tissue, positive for Aspergillus fumigatus
|
Open lung biopsy, hyphae of Aspergillus sp. |
Total IgE, 6,630 kUA/L (reference: < 260 kUA/L); immunodiffusion, positive for Aspergillus antibodies |
Amphotericin B |
Death; no autopsy performed |
Batard E et al.,(5) conducted in France in 2003 |
4 |
Exposed to vegetal dust one day prior to presentation |
Current (10 cigarette-a-day) smoker |
|
Fever, headache, myalgia, and dry cough |
Chest X-ray showed bilateral interstitial miliary infiltrates |
Bronchial aspirate, positive for A. fumigatus
|
Not stated |
Serology, negative for Aspergillus
|
Amphotericin B |
Death; postmortem lung biopsy culture positive for A. fumigatus
|
Arendrup et al.,(66. Arendrup MC, O'driscoll BR, Petersen E, Denning DW. Acute pulmonary aspergillosis in immunocompetent subjects after exposure to bark chippings. Scand J Infect Dis. 2006;38(10):945-9. http://dx.doi.org/10.1080/00365540600606580 http://dx.doi.org/10.1080/00365540600606...
) conducted in Denmark in 2006 |
5 |
Both exposed to bark chippings on the day symptoms started |
Not stated |
Heart disease |
Fever and dry cough |
Chest X-ray and HRCT scan showed bilateral interstitial infiltrates |
BAL, positive for A. fumigatus
|
Bronchial biopsy, hyphae |
Positive Aspergillus antibody titer |
Amphotericin B |
Death; postmortem histopathology suggestive of Aspergillus pneumonia |
6 |
Current (20-cigarette-a-day) smoker |
Mild COPD and Barrett's esophagus |
Dry cough, pleuritic chest pain, and sweating |
Chest X-ray showed cavitating pneumonia in the right upper lobe |
BAL, negative for fungus |
Bronchial biopsy, not suggestive of Aspergillus
|
Positive Aspergillosis precipitin test |
Itraconazole |
Improvement |
Present study |
7 |
Worked for 2 h in a deep pit containing polluted muddy water, 1 day prior to symptom onset |
Former smoker who quit 10 years prior (smoking history, 10 pack-years) |
Undiagnosed moderate obstructive lung disease |
Dyspnea, cough, and fever |
Chest X-ray showed bilateral diffuse patchy infiltrates with bilateral cavitation; chest HRCT showed multiple ill-defined nodular lesions affecting both lungs, with cavitation, some surrounded by ground-glass opacity (halo sign) |
Sputum and bronchial aspirate, positive for A. fumigatus
|
Chronic nonspecific inflammation |
Total IgE, 114 kUA/L (reference: < 64 kUA/L); skin prick test reactivity to A. fumigatus and A. niger; positivity for specific IgE and IgG antibodies against A. fumigatus
|
Itraconazole (200 mg twice a day for 2 months) |
Clinical and radiological improvement |