Bilateral pulmonary aspergilloma caused by an atypical isolate of Aspergillus terreus

A case of bilateral pulmonary aspergilloma caused by an atypical isolate of Aspergillus terreus is described. The diagnosis was established by the pre sence of septate, dichotomously branched fungal elements in freshly collect ed bronchoalveolar lavage and sputum specimens and by repeated isolation of the fungus in culture. Specific precipitating antibodies against the A. te rreus isolate were demonstrated in the patient's serum. The isolate was aty pical as it failed to produce fruiting structures on routine mycological me dia, but it did so on extended incubation on potato Rake agar and produced globose, relatively heavy-walled, hyaline accessory conidia (formerly terme d aleurioconidia) on both vegetative and aerial mycelia. Also, it produced an intense yellow diffusing pigment in the medium. The report underscores t he increasing importance of A. terreus in the etiology of pulmonary aspergi llosis. It is suggested that A. terreus antigen be included in the battery of serodiagnostic reagents to facilitate the early diagnosis of infections caused by this species.