中华结核和呼吸杂志最新文献

{"title":"[Application and research progress of anti-IL-4α monoclonal antibody dupilumab in the treatment of type 2 asthma].","authors":"Y K Liao, M J Liu, Q L Zhang","doi":"10.3760/cma.j.cn112147-20250422-00219","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20250422-00219","url":null,"abstract":"<p><p>According to the immune-inflammatory mediated characteristics of patients, asthma can be divided into two phenotypes: type 2 asthma and non-type 2 asthma. The onset of symptoms and pathophysiological changes in type 2 asthma are closely related to type 2 cytokines such as IL-4, IL-13 and IL-5. Dupilumab is a fully humanized monoclonal antibody that binds IL-4Rα and inhibits the signaling of both IL-4 and IL-13, to block type 2 inflammatory response and significantly improve asthma symptoms, reduce acute exacerbations, reduce oral corticosteroid dosage, and improve quality of life. This review summarizes the key medical evidence and recommendations from guidelines and consensus on the use of dupilumab in the treatment of type 2 asthma in recent years, and provides a reference for clinical physicians in China to use it rationally.</p>","PeriodicalId":61512,"journal":{"name":"中华结核和呼吸杂志","volume":"48 6","pages":"578-584"},"PeriodicalIF":0.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Recomment of the correctly understand and standardize the use of terms and concepts related to interstitial lung disease].","authors":"T Chen, Z J Xu","doi":"10.3760/cma.j.cn112147-20241218-00745","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20241218-00745","url":null,"abstract":"<p><p>Interstitial lung diseases (ILD) comprise a group of diseases with varied etiologies and trajectories. Some terminologies in ILD could be easily misapplied in clinical practice if just interpreted literally, which significantly hamper diagnostic accuracy and scientific reproducibility. Therefore, correct understanding and appropriate usage of these terminologies are helpful to harmonize clinical practice and research methodologies. This article will elaborate on five noun concepts that are easily misused in the diagnosis and treatment of ILD, including interstitial lung abnormality (ILA), post-coronavirus interstitial lung disease (PC-ILD), progressive pulmonary fibrosis (PPF), hypersensitivity pneumonitis (HP) and unclassifiable interstitial lung disease (uILD).</p>","PeriodicalId":61512,"journal":{"name":"中华结核和呼吸杂志","volume":"48 6","pages":"589-591"},"PeriodicalIF":0.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Antibiotics exacerbate <i>Chlamydia</i> infection of the lung and other organs and influence the gut bacterial community composition in mice].","authors":"J Y Ma, C M Zhu, Q Tian, T Y Zhang, Q Z Liu, G M Zhong, Y J Liu","doi":"10.3760/cma.j.cn112147-20240721-00420","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20240721-00420","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To investigate the effects of antibiotics on &lt;i&gt;Chlamydia muridarum&lt;/i&gt; (CM) infection in the lung and other organs of mice, the immune response, and gut bacteria. &lt;b&gt;Methods:&lt;/b&gt; C57BL/6J mice were randomly divided into antibiotic and control groups. The control group mice were given drinking water, while the antibiotic group mice were given an aqueous solution of vancomycin and gentamicin to drink for 2 weeks, in addition to intragastric administration of the solution twice. Both groups were intranasally infected with CM and the weight of the mice was monitored continuously. On the 10th day after infection, the mice were euthanized and the CM loads of several organs were analyzed. Immunofluorescence and pathological analyses of the lung tissue were performed. Serum titers of CM-specific IgG and subtypes thereof were evaluated by enzyme-linked immunosorbent assay (ELISA), and the levels of TNF-α, IFN-γ, IL-5, and IL-13 in the spleen were analyzed by flow cytometry. Mouse fecal samples were collected for qPCR analysis of the gut bacterial community composition. SPSS 26.0 software was used for data statistics and analysis of variance (ANOVA) was used for comparison between groups. &lt;b&gt;Results:&lt;/b&gt; After intranasal infection with CM, the weight of the mice in the two groups decreased from the second day; that of the control group decreased rapidly and then recovered after the sixth day, while that of the antibiotic group decreased slowly and then recovered after the eighth day. The CM loads of the lung, heart, liver, spleen, and kidney in the antibiotic group were higher (&lt;i&gt;F&lt;/i&gt;=11.06, &lt;i&gt;F&lt;/i&gt;=20.87, &lt;i&gt;P&lt;/i&gt;&lt;0.01;&lt;i&gt;F&lt;/i&gt;=7.09, &lt;i&gt;F&lt;/i&gt;=8.07, &lt;i&gt;F&lt;/i&gt;=5.66, &lt;i&gt;P&lt;/i&gt;&lt;0.05), whereas the CM loads in the lower gastrointestinal tract (jejunum, ileum, cecum, colon, and rectum) were lower (&lt;i&gt;F=&lt;/i&gt;37.23, &lt;i&gt;F&lt;/i&gt;=40.90, &lt;i&gt;F&lt;/i&gt;=18.07, &lt;i&gt;F&lt;/i&gt;=13.53, &lt;i&gt;F&lt;/i&gt;=12.51, &lt;i&gt;P&lt;/i&gt;&lt;0.01) than in the control group. The CM numbers in the antibiotic group (8.94±4.13 infectious units [IFU]/low power field) were higher than the control group (3.73±1.49 IFU/low power field) (&lt;i&gt;F&lt;/i&gt;=7.058, &lt;i&gt;P&lt;/i&gt;&lt;0.05), as determined by immunofluorescence. Pathology showed significant infiltration of inflammatory cells and greater pathological damage; the score of the antibiotic group (3.12±0.59) was higher than that of the control group (1.80±0.69) (&lt;i&gt;F=&lt;/i&gt;10.47, &lt;i&gt;P&lt;&lt;/i&gt;0.05). Serum CM-specific IgG titers in the antibiotic group were lower (&lt;i&gt;F=&lt;/i&gt;5.95, &lt;i&gt;P&lt;&lt;/i&gt;0.05), the TNF-α levels in CD4&lt;sup&gt;+&lt;/sup&gt;and CD8&lt;sup&gt;+&lt;/sup&gt;T cells in the spleen were higher (&lt;i&gt;F=&lt;/i&gt;5.93, &lt;i&gt;F=&lt;/i&gt;9.98, &lt;i&gt;P&lt;&lt;/i&gt;0.05), and the IL-13 levels were lower (&lt;i&gt;F=&lt;/i&gt;5.97, &lt;i&gt;P&lt;&lt;/i&gt;0.05; &lt;i&gt;F=&lt;/i&gt;11.70, &lt;i&gt;P&lt;/i&gt;&lt;0.01) than those in the control group. After antibiotic treatment, the proportion of &lt;i&gt;Bacteroides&lt;/i&gt; in the gut bacterial population decreased significantly (&lt;i&gt;F&lt;/i&gt;=97.57, &lt;i&gt;P&lt;/i&gt;&lt;0.01), whereas the proportion of &lt;i&gt;Firmicutes&lt;/i&gt; increased (&lt;i&gt;F&lt;/i&gt;=154.51","PeriodicalId":61512,"journal":{"name":"中华结核和呼吸杂志","volume":"48 5","pages":"448-455"},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical evaluation and interventional therapy for chronic pulmonary aspergillosis complicated by hemoptysis].","authors":"X C Tao","doi":"10.3760/cma.j.cn112147-20250320-00157","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20250320-00157","url":null,"abstract":"<p><p>Chronic pulmonary aspergillosis (CPA) complicated by hemoptysis is a clinical emergency with high mortality. This article reviews the pathophysiological mechanisms, imaging assessment methods, multi-approach interventional treatment strategies, and other therapies for CPA complicated by hemoptysis. Since CPA usually involves multiple blood vessels, combined interventional therapy using multiple approaches to embolize the culprit vessels can rapidly and effectively control hemoptysis. Interventional treatment is particularly indicated in patients with massive hemoptysis or those who do not respond to conventional medical therapy. The aim of this article is to optimize the treatment strategies for CPA complicated by hemoptysis and to further improve outcomes.</p>","PeriodicalId":61512,"journal":{"name":"中华结核和呼吸杂志","volume":"48 5","pages":"405-407"},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Multimodal imaging techniques including image-enhanced endoscopy for minimally invasive treatment of a complex tracheoesophageal and chest wall fistula: a case report].","authors":"D C Shi, Y F Zhang, X G Shi, C Lyu, Y Ma, Y G Yang, X P Shen, D L Xia, Y H Kang, X Q Wang, Q Wang, W Zhang, Y C Dong, C Bai, H D Huang","doi":"10.3760/cma.j.cn112147-20241202-00709","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20241202-00709","url":null,"abstract":"<p><p>Postoperative airway, digestive tract, and chest wall fistulas are severe complications after lung resection, often associated with high mortality. Here, we reported a case of a patient with tracheoesophageal and chest wall fistulas. After precise localization of the fistula and sinus tract using multimodal imaging techniques, a multidisciplinary treatment team was assembled, including specialists in interventional pulmonology, gastroenterology, plastic surgery, anesthesia, and pain management, to develop and implement a stepwise, personalized treatment strategy. Initially, a dual-endoscopy approach combining bronchoscopy and gastroscopy was used in a single endoscopic procedure assisted by image-enhanced endoscopy (IEE) to effectively seal the tracheoesophageal fistula. Once the fistula healed, a minimally invasive plastic surgery procedure was performed to clear the chest wall sinus tract, and once the chest wall fistula healed, the residual airway stent was successfully removed during bronchoscopy, resulting in the patient's clinical cure. Using IEE and other multimodal imaging techniques, a multidisciplinary, stepwise, personalized, minimally invasive treatment strategy centered on endoscopy and minimally invasive repair warranted further clinical investigation.</p>","PeriodicalId":61512,"journal":{"name":"中华结核和呼吸杂志","volume":"48 5","pages":"493-497"},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Endovascular treatment of chronic pulmonary aspergillosis complicated by massive hemoptysis using a dual-circulation approach: a case report].","authors":"Y J Chen, Z Y Zhu, W Yu, W Qin, J N Zhong, C H Li, F J Li","doi":"10.3760/cma.j.cn112147-20240812-00480","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20240812-00480","url":null,"abstract":"<p><p>Chronic pulmonary aspergillosis is a common disease of the respiratory system, with hemoptysis being the most frequent cause of death in such patients. This article reports a case of chronic pulmonary aspergillosis complicated by massive hemoptysis. The patient exhibited abnormal changes in vascular anatomy. A dual-circulation approach, involving both pulmonary and systemic circulations, was adopted, with punctures performed via the femoral vein, femoral artery, and radial artery, and the procedure was successfully completed. Preoperative CT angiography of the pulmonary arteries, pulmonary veins, and bronchial arteries indicated involvement of both the systemic and pulmonary arteries. Initially, dual pulmonary artery angiography was performed via the femoral vein approach, revealing dilation of the right pulmonary artery trunk and non-visualization of the distal segments due to low perfusion. Subsequently, angiography via the femoral artery approach demonstrated multiple dilated and tortuous bronchial and systemic arteries, with disordered distal branches, systemic-pulmonary artery shunts, and distal pulmonary artery aneurysmal dilation. Embolization of the pulmonary artery aneurysmal dilation was performed via the femoral vein approach, and embolization of the bronchial arteries in their normal locations was conducted via the femoral artery approach. Due to severe tortuosity of some non-bronchial systemic arteries (branches of the right subclavian artery), embolization using particulate embolic agents was carried out via the radial artery approach. The procedure was successful, and at the six-month follow-up, the patient had no recurrence of hemoptysis.</p>","PeriodicalId":61512,"journal":{"name":"中华结核和呼吸杂志","volume":"48 5","pages":"460-463"},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Multidisciplinary expert consensus on diagnosis and treatment of eosinophilic granulomatosis with polyangiitis (2025 Edition)].","authors":"","doi":"10.3760/cma.j.cn112147-20250110-00027","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20250110-00027","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Eosinophilic granulomatosis with polyangiitis (EGPA), a rare autoimmune disease affecting multiple systems, is prone to misdiagnosis and missed diagnosis due to its diverse and complex clinical manifestations, which affect the prognosis. Therefore, early diagnosis of the disease, development of standardized treatment protocols, management of complications, and multidisciplinary team collaboration are crucial. The writing group of the Multidisciplinary Expert Consensus on the Diagnosis and Treatment of Eosinophilic Granulomatosis with Polyangiitis, has comprehensively updated and revised the 2018 edition of the \"&lt;i&gt;Multidisciplinary Expert Consensus on the Diagnosis and Treatment of Eosinophilic Granulomatosis with Polyangiitis&lt;/i&gt;\" based on the latest research findings. The revision adds etiology and pathogenesis, updates diagnosis and assessment, treatment, and prognosis, and compiles 13 recommendations. This revision aims to improve the diagnostic and therapeutic capabilities of clinicians for EGPA, highlight the importance of multidisciplinary collaboration in EGPA management, provide the most up-to-date guidance for clinical practice, and consequently improve treatment outcomes and patients' quality of life.The recommendations are listed below.&lt;b&gt;Recommendation 1:&lt;/b&gt; Patients with asthma, peripheral blood eosinophilia, and damage to other systems should be suspected of having EGPA (1, B).&lt;b&gt;Recommendation 2:&lt;/b&gt; Patients suspected of having EGPA should undergo a full examination and assessment. ANCA testing should be performed in all such patients. If feasible, biopsy of the affected tissue is also recommended (1, B).&lt;b&gt;Recommendation 3:&lt;/b&gt; The diagnosis of EGPA should be based on highly suggestive indicative clinical features, laboratory tests, imaging, and objective evidence of vasculitis. Differential diagnosis and multidisciplinary assessment are essential. The 1990 ACR or 2022 ACR/EULAR classification criteria for EGPA are recommended for diagnosis (1, B).&lt;b&gt;Recommendation 4:&lt;/b&gt; All patients with EGPA should be assessed for disease severity and status (1, A).&lt;b&gt;Recommendation 5:&lt;/b&gt; The treatment goal for EGPA is to achieve disease remission promptly, maintain long-term organ function, prevent disease progression, enhance quality of life for patients, and increase survival rates (1, D).&lt;b&gt;Recommendation 6:&lt;/b&gt; Treatment of EGPA should be based on disease severity (severe or non-severe) and status (active, remission, new-onset, responsive, refractory, relapsed) (1, B).&lt;b&gt;Recommendation 7:&lt;/b&gt; For induction of remission in patients with active severe EGPA, corticosteroid pulse therapy or corticosteroids in combination with cyclophosphamide or rituximab are recommend (1, B).&lt;b&gt;Recommendation 8:&lt;/b&gt; For induction of remission in patients with active non-severe EGPA, the preferred treatment is corticosteroids with mepolizumab. Other options include corticosteroids with methotrexate, azathioprine, or mycophenolate mofetil (1, A).&lt;b&gt;Re","PeriodicalId":61512,"journal":{"name":"中华结核和呼吸杂志","volume":"48 5","pages":"418-439"},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Advances in perioperative management of patients with obstructive sleep apnea].","authors":"Y Y Deng, J M Luo, Y Xiao","doi":"10.3760/cma.j.cn112147-20240910-00540","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20240910-00540","url":null,"abstract":"<p><p>Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder. Patients with OSA are at significant risk in the perioperative period. Therefore, improving the management of OSA in the perioperative period has become increasingly important. However, some studies have shown that whether the first-line treatment for OSA, positive airway pressure (PAP) therapy, is effective in the perioperative period remains controversial. This review aims to summarize the latest research advances in the perioperative diagnosis and treatment of OSA, highlighting the role of OSA assessment and treatment in improving patient's safety and outcomes during the perioperative period.</p>","PeriodicalId":61512,"journal":{"name":"中华结核和呼吸杂志","volume":"48 5","pages":"476-480"},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Pulmonary vascular interventions: innovating through adaptation and advancing through differentiation].","authors":"J Li, J Wan","doi":"10.3760/cma.j.cn112147-20250315-00143","DOIUrl":"10.3760/cma.j.cn112147-20250315-00143","url":null,"abstract":"<p><p>Pulmonary vascular intervention technology, with its minimally invasive and precise advantages, has been a groundbreaking advancement in the treatment of pulmonary vascular diseases. Techniques such as balloon pulmonary angioplasty (BPA), pulmonary artery stenting, and percutaneous pulmonary artery denervation (PADN) have significantly improved the prognoses for conditions such as chronic thromboembolic pulmonary hypertension (CTEPH), pulmonary artery stenosis, and pulmonary arterial hypertension (PAH). Although based on coronary intervention (PCI) techniques such as guidewire manipulation and balloon dilatation, pulmonary vascular interventions require specific modifications to address the unique characteristics of the pulmonary circulation, low pressure, thin-walled vessels, and complex branching, to mitigate risks of perforation and thrombosis. Future directions include the development of dedicated instruments, multi-modality imaging guidance, artificial intelligence-assisted procedures, and molecular interventional therapies. These innovations aim to establish an independent theoretical framework for pulmonary vascular interventions, facilitating their transition from \"adjuvant therapies\" to \"core treatments\" in clinical practice.</p>","PeriodicalId":61512,"journal":{"name":"中华结核和呼吸杂志","volume":"48 5","pages":"401-404"},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[A case of allergic bronchopulmonary mycosis caused by <i>Triodiomyces crassus</i>].","authors":"Q F Yan, Z L Sun, Q Wang, J Y Zhou","doi":"10.3760/cma.j.cn112147-20240831-00523","DOIUrl":"10.3760/cma.j.cn112147-20240831-00523","url":null,"abstract":"&lt;p&gt;&lt;p&gt;There are few published cases of non-&lt;i&gt;aspergillus&lt;/i&gt; allergic bronchopulmonary Mycosis (ABPM) worldwide. Here we report the first case where the fungus &lt;i&gt;Triodiomyces crassus&lt;/i&gt; was found to be the causative pathogen of non-&lt;i&gt;aspergillus&lt;/i&gt; ABPM. This study provided an overview of the diagnosis, treatment and follow-up of the case. In May 2018, a 60-year-old male patient presented with a 1-month history of dry cough with mild chest tightness. He had no history of asthma and no clinically reported illness. The routine pulmonary auscultation on admission revealed no abnormalities. Subsequent laboratory tests revealed marked peripheral blood eosinophilia and an increased level of serum total IgE. However, the specific IgE antibody test for &lt;i&gt;Aspergillus fumigatus&lt;/i&gt; was negative. A chest CT scan showed peribronchial consolidation in the right upper lobe with high-attenuation mucoid impaction in the corresponding bronchi. Bronchoscopy confirmed these mucus plugs. The bronchoscopic biopsy specimen showed a large number of eosinophils and fungal hyphae. The fungal smear from the bronchial lavage fluid showed fungal hyphae, although the fungal culture showed no growth. A CT-guided transthoracic needle biopsy was performed on the lesion in the right upper lung, which showed significant eosinophil infiltration in the pulmonary parenchyma. The biopsy specimen was cultured and yielded colonies with a yeast-like appearance. Microscopic examination of these colonies revealed yeast-like fungi and pseudohyphae. The fungal morphology observed in the bronchial wash smear and the pathology of the bronchoscopic biopsy were consistent with that seen in the cultured colonies. The organism was identified as &lt;i&gt;Triodiomyces crassus&lt;/i&gt; through sequencing of the internal transcribed spacer (ITS) region of its ribosomal DNA (rDNA). The patient was initially treated with a 2-week course of voriconazole, 200 mg orally twice daily, but there was no significant improvement in symptoms. Follow-up bronchoscopy revealed persistent obstructive mucus plugs. Based on these findings, the diagnosis was revised to ABPM caused by &lt;i&gt;Triodiomyces crassus&lt;/i&gt; rather than an invasive fungal infection, and corticosteroid treatment was added, with prednisone administered at 20 mg/day. After two weeks, the patient coughed up a mung-bean-sized gelatinous substance (mucus plug), and there was a marked improvement in cough and chest tightness. Treatment continued for a further two weeks, but was then discontinued by the patient's own decision. The patient returned for the first follow-up, 77 days after the initial admission. Clinical symptoms had subsided. Repeat tests showed normal eosinophil counts and total IgE levels, and a chest CT scan showed significant absorption of the lesions, with only mild bronchiectasis remaining. As the patient had discontinued steroid therapy and there were no recurrent symptoms, no further medication was prescribed, but continued observation was ","PeriodicalId":61512,"journal":{"name":"中华结核和呼吸杂志","volume":"48 5","pages":"464-469"},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}