Aspergillus terreus and Aspergillus fumigatus as successive etiologic agents in a patient with allergic bronchopulmonary aspergillosis

A case of allergic bronchopulmonary aspergillosis (ABPA) in a 26-year-old m ale patient is described. Immunological and mycological evidence indicated that Aspergillus terreus and A. fumigatus served as successive etiologic ag ents. initially only A. terreus was repeatedly isolated from the patient's sputum, sputum plugs and bronchial aspirate. Also, A. terreus gave a strong er precipitin band in immunodiffusion test than that obtained with A. fumig atus. Upon review of the patient one year later, cultures of sputum samples consistently yielded A. fumigatus. Immunodiffusion tests at this time reve aled a stronger precipitin band against A. fumigatus than that with A. terr eus. To the best of our knowledge, the role of A. terreus and A. fumigatus as successive etiologic agents of ABPA has not been reported previously. A review of 7 published cases of ABPA due to A. terreus is included and the g rowing clinical importance of this species is emphasized.