PEDIATRICS Vol. 102 No. 6 December 1998, pp. 1480-1482
Received Apr 20, 1998; accepted Jun 18, 1998.
, and
* Divisions of Pediatric Pulmonology and
Allergy, Immunology,
and Infectious Diseases
Children's Hospital of Pittsburgh and University of Pittsburgh
Pittsburgh, PA 15213
This article describes a child with cystic fibrosis (CF) and allergic bronchopulmonary mycosis caused by Tricosporon beigelii. An 11-year-old boy with CF failed to respond to conventional treatment for a pulmonary exacerbation. Bronchial washings contained copious budding yeast forms, subsequently identified as T beigelii. Total serum immunoglobulin E was elevated and precipitating antibodies to T beigelii were positive. Together these findings support the diagnosis of allergic bronchopulmonary mycosis. The patient improved with antifungal therapy and systemic glucocorticoid therapy. The pathologic potential of yeast in the airways of patients with CF is unclear. The diagnosis of non-Aspergillus allergic bronchopulmonary mycosis requires a high degree of suspicion and has potentially important implications for the management of patients with CF.
Key words: cystic fibrosis, allergic bronchopulmonary aspergillosis, allergic bronchopulmonary mycosis, Tricosporon beigelii.