Allergic bronchopulmonary mycosis caused by Schizophyllum commune in a patient with severe food allergy and asthma.

Schizophyllum commune is a basidiomycete. Allergic bronchopulmonary mycosis (ABPM) is mainly caused by Aspergillus species; however, that caused by S. commune is occasionally found, especially in Japan. The patient was a 46-year-old female with a history of severe food allergies, asthma, and anaphylaxis. Atelectasis and bronchiectasis were observed in the left lower lobes of the lungs. The patients showed high levels of IgG and IgE against Aspergillus; however, anti-Asp f 1 IgE, Aspergillus antigen in serum, and Aspergillus species in respiratory specimen cultures were not detected. S. commune was only slightly detected in the culture of bronchial lavage fluids, but not in mucus plugs, and was identified using MALDI-TOF mass spectrometry and the gene sequence of the internal transcribed spacer region. However, clamp connections of the hypha were not observed. Seven of the ten clinical diagnosis criteria of ABPM were met, thus we diagnosed with ABPM caused by S. commune. The patient was treated with 200 mg once daily of oral itraconazole for approximately 10 months and 30 mg (gradually reduced) once daily of oral prednisolone for approximately 7 and a half months.