A Study on the Fungal Flora in the Lung of Human Necropsy Cases
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概要
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The lungs or seventy three necropsy cases, most of which were the cases of unexpected sudden deaths, from the Tokyo Metropolitan Medical Examiner Office were used for this study. Materials for culture were taken aseptically from the respiratory parenchyma of the lungs (subpleural region). The six areas of the lungs were examined in each cases, respectively. Peptone glucose chloramphenicol agar media was used for the culture, and isolated filamentous fungi and yeasts were identified by routine procedure. The areas, from which the materials for culture were taken, were examined histopathologically. The results obtained were as follows1) Among the 73 cases, fungi were isolated from 60 cases. Namely, filamentous fungi were detected from 38 cases, yeasts were isolated from 7 cases, and both filamentous fungi and yeasts were obtained from 15 cases. No pulmonary fungus infection was disclosed in the cases examined.2) Filamentous fungi were isolated from 53 cases (72.6%). The number of isolated filamentous fungus colonies was under 5 in the almost all the fungi positive cases which included the cases without any pathological changes in the lungs. There was no definite relation between the presence or grade of inflammatory changes of the lungs and detection rate and genus of filamentous fungi. 272 strains of filamentous fungi were isolated from the 53 cases, and the most frequently isolated fungi was Penicillium, and then Aspergillus, and Basidiomycetous fungi. It was noteworthy finding that the genus or species of the isolated filamentous fungi from the human lung were only the limited genus or species of air borne filamentous fungi.3) Yeasts were isolated from 22 cases (30.1%). The rate of yeasts isolation was higher in the cases with bronchitis or bronchopneumonia than in the cases without any inflammatory changes. Candida albicans and Torulopsis glabrata were isolated most frequently.4) Investigations and discussions were made on relations between the rate of fungus isolation and pleural adhaesion, air contents, and regional incidence of the examined areas, and age, sex, post-mortem hours, body temperature of the examined cases, room temperature and seasonal difference at which the materials for culture were taken.5) From the results obtained, the authors concluded that even a healthy respiratory parenchyma of the human lung can not be assumed as aseptic, but the isolated fungi from the lung without fungus infection were a few in number, and the genus or species of the fungi isolated from the respiratory parenchyma were only the limited genus or species of air borne fungi. Furthermore, an attainability of air borne fungi to the respiratory parenchyma of the human lung was discussed in connection with the pathogenesis of opportunistic fungus infections.
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