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Bronchopulmonary torulopsosis

R Patterson, B S Samuels, J J Phair

International Archives of Allergy and Applied Immunology

|January 1, 1982

Summary

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This study identifies Torulopsis glabrata as a cause of respiratory disease, distinct from allergic bronchopulmonary aspergillosis. Elevated IgG antibodies, not IgE, were key diagnostic indicators in this rare yeast infection.

Area of Science:

Medical Mycology
Immunology
Pulmonology

Background:

Allergic bronchopulmonary aspergillosis (ABPA) is a significant pulmonary disease.
Distinguishing ABPA from other fungal or yeast-related respiratory conditions is clinically important.
Torulopsis glabrata (Candida glabrata) is typically a commensal yeast, rarely causing invasive disease.

Observation:

A patient presented with symptoms mimicking ABPA.
Diagnostic workup excluded ABPA but identified Torulopsis glabrata as the causative agent of respiratory disease.
The patient showed no signs of invasive fungal infection.

Findings:

Elevated total serum IgE levels were noted, but IgE antibodies against T. glabrata were undetectable.
Significantly elevated IgG antibodies against T. glabrata antigen were detected via radioimmunoassay, aiding diagnosis.

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Treatment with prednisone resulted in clinical and radiographic improvement.

Prednisone therapy led to a marked decrease in total serum IgE and moderate decreases in IgG and IgA.

Implications:

Bronchopulmonary torulopsosis, though rare, should be considered in the differential diagnosis of ABPA-like presentations.
The diagnostic utility of IgG antibodies against T. glabrata is highlighted.
The distinct immunological profile (elevated IgG, not IgE) suggests a non-allergic mechanism in this case, precluding the term 'allergic bronchopulmonary torulopsosis'.