A 31-year-old housewife with a history of recurrent eczema and otitis media was admitted in March 1981, because of progressive dyspnea. On admission she was semicomatotic, febrile and cyanotic. Inspiratory crackles were heard all over the lung. Eczema was present on the scalp. Chest X-ray showed bilateral consolidation. Arterial blood gas analysis showed marked hypoxemia. She was immediately placed on CPPV, large doses of antibiotics and hydrocortisone. During 10 days stay in ICU, her condition improved gradually.
Her chest X-ray two weeks after admission showed residual scattered fine nodular densities with a partially confluent area. Because she had been using an ultrasonic humidifier in her home for four months before admission, an attempt to provocate the condition using her own humidifier was made. Four hours after humidifing besides her bed for one hour, a fever of 37.8°, leukocytosis and a decrease of vital capacity developed. Chest X-ray 22 hours after provocation showed new scattered fine densities. Microscopic examination of lung tissues obtained by transbronchial lung biopsy showed infiltration of lymphocytes with a few neutrophiles and eosinophiles to the alveolar wall.
Candida albicans was cultured from water in the humidifier and precipitating antibody to this organism was detected in her serum. However inhalation provocation test using this organism was not performed.
