Allergic bronchopulmonary mycosis to Fusarium vasinfectum in a child.

BACKGROUND

A 12-year-old boy with asthma and 6 years of recurrent pneumonias who had normal serum immunoglobulin concentrations was suspected of having allergic bronchopulmonary aspergillosis (ABPA).

OBJECTIVE

To search for and secure a fungal etiology for a child who did not have ABPA but was suspected of having an allergic bronchopulmonary mycosis.

METHODS

Immediate skin testing with fungal extracts, high resolution computerized tomography, and establishment of an ELISA procedure to detect serum IgE and IgG antibodies to Fusarium vasinfectum.

RESULTS

Immediate skin reactivity was present for Fusarium, Cladosporium, Helminthosporium, and Aspergillus fumigatus. The ELISA demonstrated serum IgE and IgG antibodies to Fusarium vasinfectum 8.5 and 5.6 times nonatopic control sera.

CONCLUSIONS

This 12-year-old with asthma has sufficient criteria for a diagnosis of allergic bronchopulmonary mycosis (ABPM) to Fusarium vasinfectum. Bronchiectasis was not present despite recurrent pneumonias and hemoptysis. This case appears to be the first pediatric example of ABPM to Fusarium species, a fungus more recognized for causing rotting of tomatoes and melons than human disease.