Schizophyllum commune-associated allergic bronchopulmonary mycosis in a postoperative lung cancer patient: A case report and comprehensive literature review.

RATIONALE: Schizophyllum commune (S commune), a basidiomycetous fungus, is increasingly recognized as an important cause of allergic bronchopulmonary mycosis, particularly in immunocompetent individuals with a history of respiratory surgery, chronic sinusitis, or structural airway abnormalities.

PATIENT CONCERNS: A 71-year-old female with a prior right upper lobectomy for lung cancer and a history of invasive fungal sinusitis presented with recurrent dyspnea, cough, and chest tightness.

DIAGNOSES: The diagnosis was confirmed by fungal culture and 18S rRNA sequencing, along with significantly elevated total serum immunoglobulin E (541 IU/mL), specific immunoglobulin E to S commune (15.2 kU/L), and peripheral eosinophilia (8.0%).

INTERVENTIONS: The patient was treated with voriconazole and inhaled corticosteroids/formoterol for asthma control.

OUTCOMES: Marked improvement in symptoms and radiologic findings was observed after 1 month of treatment, with sustained improvement over 3 months.

LESSONS: This case highlights the diagnostic challenges in distinguishing S commune-induced allergic bronchopulmonary mycosis and emphasizes the importance of considering this pathogen even in immunocompetent patients.