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doi:10.1378/chest.06-2346
(Chest. 2007; 131:1237-1239)
© 2007 American College of Chest Physicians
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Corynebacterium ulcerans Infection of the Lung Mimicking the Histology of Churg-Strauss Syndrome*

Shin-ichi Nureki, MD, PhD; Eishi Miyazaki, MD, PhD; Osamu Matsuno, MD, PhD; Ryuichi Takenaka, MD; Masaru Ando, MD, PhD; Toshihide Kumamoto, MD, PhD; Tadao Nakano, PhD; Kiyofumi Ohkusu, PhD and Takayuki Ezaki, MD, PhD

* From the Divisions of Pulmonary Disease (Drs. Nureki, Miyazaki, Matsuno, Takenaka, and Ando) and Neurology and Neuromuscular Disorders (Dr. Kumamoto), Third Department of Internal Medicine, Oita University Faculty of Medicine, and Clinical Laboratory Center of Oita University Hospital (Dr. Nakano), Yufu; and Department of Microbiology, Regeneration, and Advanced Medical Science (Drs. Ohkusu and Ezaki), Gifu University Graduate School of Medicine, Gifu, Japan.

Correspondence to: Shin-ichi Nureki, MD, PhD, Division of Pulmonary Disease, Third Department of Internal Medicine, Oita University Faculty of Medicine, 1–1 Idaigaoka, Hasama-machi, Yufu, Oita 879-5593, Japan; e-mail: nureki{at}med.oita-u.ac.jp

We report the first case of pulmonary Corynebacterium ulcerans infection mimicking Churg-Strauss syndrome (CSS). Productive cough, fever, general fatigue, and weight loss developed in a 50-year-old man. Laboratory data revealed prominent eosinophilia and elevated serum IgE. On chest images, multiple nodules and cavities were predominantly detected in the right lung. Histopathologic examination showed necrotizing granulomas and vasculitis with massive eosinophilic infiltration identical to the findings seen in CSS; however, clusters of Gram-positive, coryneform rods were observed in the alveolar spaces. A toxigenic strain of C ulcerans was isolated from lung tissue. The patient was treated with antibiotics, and a favorable clinical course ensued.

Key Words: Churg-Strauss syndrome • Corynebacterium ulcerans • eosinophil






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