Allergic bronchopulmonary disease caused by fungi other than Aspergillus.

Allergic bronchopulmonary disease caused by fungi other than Aspergillus Sir,-Dr McAleer and colleagues (Thorax 1981 ;36:338) report allergic bronchopulmonary disease related to fungal species other than aspergillus.We have identified two similar cases in an equivalent climatic region.Case I A 29-year-old man with a history of childhood asthma was found to have a persisting asymptomatic right upper lobe opacity in a mass miniature x-ray survey in 1972.Radiographic appearances were consistent with mucoid impaction.Blood eosinophils were 2300 per cm.Aspergillus prick tests were negative.A bronchial cast and viscus mucus were removed from the right upper lobe at bronchoscopy.These contained numerous fungal elements.Culture of these specimens grew Helminthorporum sp only.Case 2 A 28-year-old man with a history of childhood asthma was found to have a persisting asymptomatic right upper lobe opacity on mass miniature x-ray survey in 1976.The appearances suggested mucoid impaction.Blood eosinophils were 752 cm.Precipitins against aspergillus were negative.Thick viscid mucus removed from the right upper bronchus at bronchoscopy contained many mycelial elements.Culture grew only Curvalaria sp.The cultures in both cases were confirmed at the School of Tropical Health, University of Sydney.The patients lived at latitude 19°S on the eastern seaboard of Australia.The latitude and climate areequivalent to the regions where Dr McAleer's cases originated, but on the other side of the continent.In a 10-year period from 1971 in this region approximately 10-20 new cases of mucoid impaction caused by Aspergillus sp have been identified.Our observations, together with those of Dr McAleer and colleagues, sug- gest that these other types of organism are also a signifi- cant cause of allergic bronchopulmonary disease across the tropical zone of Australia.