Bronchial Mucoid Impaction Due to the Monokaryotic Mycelium of Schizophyllum commune

Abstract

We report, to our knowledge, the first case of mucoid impaction of the bronchi due to a hypersensitivity reaction to the monokaryotic mycelium of Schizophyllum commune. The patient was hospitalized because of mild asthma attacks, persistent cough, peripheral eosinophilia, and "gloved finger" shadows on a chest roentgenogram. Bronchoscopic examination disclosed mucoid impactions that consisted of accumulations of eosinophils, Charcot-Leyden crystals, and nondichotomously branched hyphae in B3, B9, and B10 of the left lung. Cultures of the mucous plugs and sputum samples yielded white, felt-like mycelial colonies that were later identified as the monokaryotic mycelium of S. commune by use of mating tests with established monokaryotic and dikaryotic strains of S. commune. The results of tests for serum antibody to S. commune cytosol antigen were positive. Repeated bronchoscopies for performing bronchial toilet were effective in removing the mucous plugs and relieving the patient's symptoms. We suggest that the monokaryotic mycelium of S. commune should be considered as one of the fungi that can cause hypersensitivity-related lung diseases.

Mucoid Impaction Caused by Monokaryotic Mycelium of Schizophyllum commune in Association with Bronchiectasis.

“…Neither accumulation of eosinophils nor Charcot-Leyden crystals were present in the mucous plugs. Several reports involving the lung were described as cases of allergic bronchopulmonary mycosis (ABPM) (5,6). However, the above-mentioned findings suggested that she had only mucoid impaction independent of hypersensitivity reactions caused by S. communein association with bronchiectasis.…”

“…Reports of infection caused by S. commune are rare ( 1-^). Reports involving the lung include cases of allergic bronchopulmonary mycosis (ABPM)in healthy female (5,6) and fungus ball of the lung (4). To our knowledge, no basidiomycete has been reported from a case of mucoid impaction in association with bronchiectasis.…”

Two cases of Schizophyllum asthma: Is this a new clinical entity or a precursor of ABPM?

“…Although it is well-known that Schizophyllum commune (S. commune), one of the BM fungi, causes mucoid impaction of bronchi (MIB) [11], allergic bronchopulmonary mycosis (ABPM) [12] and allergic fungal sinusitis (AFS) [13], it still remains unclear whether this fungus really causes or triggers asthma symptoms similar to Aspergillus species [14] or not.…”

Development of Molecular Methods for Identification of Schizophyllum commune from Clinical Samples

“…Schizophyllum commune Fries 1821 (Schizophyllaceae, Aphyllophorales) is one of them and has been described elsewhere as a suspected cause of onychomycosis (16), basidioneuromycosis (2), an allergic bronchopulmonary mycosis (12), mucoid impaction of the bronchi (1,5), a fungus ball in the lung (27), an ulcerative lesion of the hard palate (23), a brain abscess (24), and several cases of both maxillary and allergic fungal sinusitis (4,6,14,18,25,28,29). A review of cases has been published by Kamei et al (13).…”