A 29-year-old white man was well until progressive dyspnea developed. One month before entry, he began to develop coryza, myalgia, anorexia, fever, and headache. Two weeks prior to admission, a nonproductive cough developed.
He was a carpenter who had been restoring a factory roof in Sao Paulo, closed down for several years. A large amount of dust was kicked up while working on the stuffy roof.
On admission, the patient appeared well, with mild dyspnea. Temperature was 38.3°C, pulse was 90 beats per minute, and respirations were 20/min. Blood pressure was 100/70 mm Hg. Inspiratory crackles were heard in both lung bases. Buy Asthma Inhalers Online
The hematocrit value was 43 percent, the peripheral blood leukocyte count was 16,700 cell/cu mm with 3 percent eosinophils, 70 percent neutrophils and 6 percent band forms. Specimens of stool contained no ova or parasites. Arterial blood gas values (room-air breathing) showed pH, 7.39; Po2, 76 mm Hg; Pco2, 22 mm Hg. Chest roentgenogram revealed a bilateral interstitial infiltrate with a diffuse micronodular pattern. Pulmonary function studies showed that FVC was 3.47 L (68 percent of predicted), FEV, was 3.28 L (81 percent), FEF25-75% was 4.83 Us (103 percent), and Deo was 31.7 ml/min/mm Hg (104 percent).
Respiratory Failure Caused by Adiaspiromycosis: Case Reports (Part 3)