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Respiratory failure caused by adiaspiromycosis
J V Barbas Filho1, M B Amato, D Deheinzelin
1Pulmonary Division, Hospital das Clinicas, São Paulo, Brazil.
Abstract:
Adiaspiromycosis is a rare pulmonary disorder caused by the fungus Emmonsia crescens (or Chrysosporium parvum var crescens). According to the amount of inhaled conidia, man may develop symptomatic disease. After reaching the alveoli, the adiaconidia do not multiply or disseminate, but will induce a granulomatous inflammatory reaction that may lead to fatal respiratory failure. Up to now, only five cases of disseminated pulmonary infection have been documented. This work describes the occurrence, in Brazil, of two further cases of symptomatic disease with diffuse interstitial infiltrates and severe functional impairment. Possible massive infestation during activities in closed and stuffy environments is suggested. The specific diagnosis was troublesome and could not be made by cultures, skin tests or bronchoalveolar lavage. Both patients were successfully treated, but a spontaneous resolution of the process is seriously considered.
Insights
Adiaspiromycosis, a rare fungal lung infection, caused severe respiratory issues in two Brazilian patients. Diagnosis proved challenging, but successful treatment was achieved, with spontaneous resolution also considered.
Area of Science:
- Mycology
- Pulmonology
- Infectious Diseases
Background:
- Adiaspiromycosis is a rare pulmonary disease caused by Emmonsia crescens.
- Infection occurs through inhalation of fungal conidia.
- The fungus does not multiply in the alveoli but triggers inflammation, potentially leading to respiratory failure.
Observation:
- Two new cases of symptomatic adiaspiromycosis were documented in Brazil.
- Patients presented with diffuse interstitial infiltrates and severe respiratory impairment.
- Massive fungal infestation in closed, stuffy environments was hypothesized as the cause.
Findings:
- Specific diagnosis was difficult, with cultures, skin tests, and bronchoalveolar lavage proving ineffective.
- Both patients responded well to treatment.
- The possibility of spontaneous resolution of the condition was noted.
Implications:
- This report expands the documented cases of disseminated adiaspiromycosis.
- It highlights diagnostic challenges associated with this rare fungal infection.
- It suggests potential environmental risk factors for massive infestation.