| pubmed-article:572967 | pubmed:abstractText | In a patient properly treated for a previous cavitary tuberculosis, we had the surprise, after hemoptyses, to find a sleigh-bell shaped picture suggesting an intra-cavitary aspergilloma with a very special mycosis with Allescheria Boydii. Proof was provided by the presence of the fungus in direct examination and in culture in bronchial secretions. Surgical exeresis did not cure the patient and a secondary recurrence appeared on which antifungal drugs were ineffective. Antigens were made from the strain. They are used for immunoprecipitations tests. Only the patient's serum is positive; 82 serum test (18 concerned patients with visceral mycosis of farmer's lung disease) remained negative. Twenty two observations or pulmonary allescheriosis were recorded in the world. These figures are certainly below the truth. Three practical consequences can be drawn: --for an intra-cavitary mycetoma, with negative anti-aspergillus precipitins, such a disease must be kept in mind and the fungus looked for in bronchial secretions and specific immuno-precipitation test done; --any mycotic growth must be systematically cultured to determine the type of fungus; --for therapy, if diagnosis was made before the intervention, an antifungal treatment either local or general must be associated to the surgical treatment (contrary to aspergilloma treatment). | lld:pubmed |
