PMC8346684_01
CT images of the patient. CT images indicated bronchiectasis in both lungs, multiple calcified nodules and patchy infiltrates in the right lung before treatment (A,B,C). The lung fields are slightly clearer and the right lung is less heavily infiltrated after the diagnosis and treatment for Microascus cirrosus for 2 months (D,E,F). Moreover, there was no recurrence or progression after drug withdrawal for three month (G,H,I) and almost one year (J,K,L).
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Chest CT indicated bronchiectasis accompanied by infection in the middle and lower lobe of the right lung, multiple patchy infiltrates of both lungs with increased mediastinal lymph nodes (Fig. 1A,B,C). Two months later, chest CT demonstrated a slight improvement (Fig. 1D,E,F). Moreover, there was no radiologic progression during another 3 months (Fig. 1G and H,I) and one year (Fig. 1J,K,L) of follow-up.
Fiberoptic bronchoscopy of the patient before antifungal treatment. Fiberoptic bronchoscopy showed a few dark red blood stains and a lot of purulent secretions in the bilateral bronchus, especially in the right middle lobe (RML) and the left upper lobe (LUL) bronchus. RUL: right upper lobe, RLL: right lower lobe. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)
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Fiberoptic bronchoscopy before antibiotic administration (Fig. 2) showed a few dark red blood stains and a lot of purulent secretions in the bilateral bronchus, especially in the right middle lobe and the left superior lobar bronchus.
Colonies of Microascus cirrosus cultured from bronchoalveolar lavage (BAL) fluid of the patient. Front view(A) and reverse view(B) of M. cirrosus colonies cultured on slants of Sabouraud 's dextrose agar. They were white velvety and brownish-gray pigmented colonies.
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BAL fluid from the right middle bronchus was incubated on slants of Sabouraud 's dextrose agar, many white velvety and brownish-gray pigmented colonies grew after 10 days incubation (Fig. 3).