A case of acute eosinophilic pneumonia caused by inhalation of Trichosporon terrestre.

We present the diagnostically challenging case of an 18-yr-old Japanese woman who presented with fever, nonproductive cough, and acute respiratory distress. Her chest radiograph showed diffuse interstitial infiltrates and bilateral pleural effusions. Eosinophilic pneumonia was diagnosed by bronchoalveolar lavage and transbronchial lung biopsy. She was treated with minocycline, and was discharged in 2 wk. However, within 3 h of returning home, she experienced a recurrence. She showed positive immediate, Arthus, and delayed-type skin reactions and positive lymphocyte stimulation test to an antigen derived from Trichosporon terrestre, which was isolated from dust in her home. In addition, a bronchoprovocation test with the same antigen caused a nonproductive cough with fever, hypoxemia, and peripheral eosinophilia. We concluded that T. terrestre was the causal agent of the acute eosinophilic pneumonia.