Recurrent Pulmonary Infection Caused by Schizophyllum commune: A Case Report and Management of Inflammation.

This case report documents a recurrent pulmonary infection caused by Schizophyllum commune in a 59-year-old woman with repeated admissions for cough and sputum production. Using mNGS on BALF, S. commune sequences were identified. The patient's clinical symptoms, lab results, and imaging features aligned with six criteria from Asano's assessment table, confirming ABPM. During treatment, bronchoscopic airway clearance, antifungal agents, and inhaled corticosteroids proved effective. The case highlights mNGS's role in diagnosing rare fungal infections and the need for individualised antifungal therapy. Azithromycin's potential anti-inflammatory effects were noted, though its specific application in ABPM requires further study. Caution is advised in future use, with more research needed on its mechanism in such cases.