A case of allergic bronchopulmonary aspergillosis caused by Aspergillus oryzae which is used for brewing bean paste (miso) and soy sauce (shoyu)
Kino, T.; Chihara, J.; Mitsuyasu, K.; Kitaichi, M.; Honda, K.; Kado, M.; Izumi, T.; Oshima, S.; Uesaka, I.; Maeda, K.; Kurozumi, M.; Oota, S.
Nihon Kyobu Shikkan Gakkai Zasshi 20(4): 467-475
1982
ISSN/ISBN: 0301-1542 PMID: 7202073 Document Number: 194407
A 16-yr-old boy, a student at a senior high school, was admitted complaining of cough, sputa and dyspnoea. His chest X-ray film revealed atelectasis of the right upper lobe of the lung. The shadow waxed and waned, and finally new shadows appeared in the left lower lung field even after intensive chemotherapy. Further findings of peripheral blood eosinophilia, elevated serum IgE level and Aspergillus cultured from sputum suggested a diagnosis of ABPA caused by A. fumigatus. However, tests using the allergenic extract of A. fumigatus did not fulfill the allergological criteria of ABPA; namely, results were positive in immediate skin reaction, but negative in both late skin reaction and precipitin test on agar gel. From the fact that his family manufactures miso bean paste and soy sauce and A. oryzae is used in their manufacture, A. oryzae was suspected as the causative agent of his disease. A. oryzae was then isolated from bronchial lavage-fluid. Allergological tests using the culture medium of A. oryzae showed positive immediate and late skin reactions and positive precipitin on agar gel. Much higher binding of 125I-anti-IgE was obtained in the radioallergosorbent test (RAST) on A. oryzae than in the RAST on A. fumigatus. Thus, the case was diagnosed as ABPA caused by A. oryzae. It is concluded that since A. oryzae is used for making miso, soy sauce, and sake in Japan, A. oryzae should be considered as an important causative agent of ABPA in Japan.