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 male patient is described. Immunological and mycological evidence indicated that Aspergillus terreus and A. fumigatus served as successive etiologic agents. initially only A. terreus was repeatedly isolated from the patient's sputum, sputum plugs and bronchial aspirate. Also, A. terreus gave a stronger precipitin band in immunodiffusion test than that obtained with A. fumigatus. Upon review of the patient one year later, cultures of sputum samples consistently yielded A. fumigatus. Immunodiffusion tests at this time revealed a stronger precipitin band against A. fumigatus than that with A. terreus. 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 growing clinical importance of this species is emphasized.