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KMID : 1100820230130010027
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Laboratory Medicine Online
2023 Volume.13 No. 1 p.27 ~ p.30
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A Rare Case of Bronchiectasis with Mucoid Impaction Caused by Schizophyllum commune in an Immunocompetent Woman in South Korea
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Moon Sook-In
Jung Ka-Yeon
Lee Hyun-Joo
Ham Soo-Youn
Park Seong-Jun
Cho Eun-Hye
Woo Hee-Yeon
Park Hyo-Soon
Lim Seong-Yong
Kwon Min-Jung
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Abstract
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Schizophyllum commune is one of most widely distributed fungal species, often found on dead and decaying organic matter. Only a few cases of S. commune infections in immunocompetent patients, including the sinus, sino-orbital, bronchopulmonary, and extra-pulmonary areas have been reported. A 52-year-old female patient presented with symptoms of cough, whitish sputum, and chest discomfort lasting approximately one month. The patient denied any relevant medical history. Chest radiography revealed a mass-like consolidation at the right lower lobe. Bronchoscopy showed thick, white-yellowish mucoid plugs on several bronchi on the right middle lobe. Transbronchial biopsy and aspiration were performed. Gomori’s methenamine silver staining on a prepared paraffin block and fungal culture revealed a few scattered degenerated fungal hyphae. DNA amplification and sequencing analysis of the Internal Transcribed Spacer gene demonstrated 100% identity with S. commune; access number MK029865.1. The patient was diagnosed with bronchiectasis with mucoid impaction caused by S. commune fungal infection and recovered fully after 4 weeks of oral administration of itraconazole 200 mg twice a day. In Korea, there have been only two cases of fungal infections caused by S. commune in immunocompetent patients. The cases were allergic fungal sinusitis and sino-orbital infection. This report provides additional evidence that invasive fungal infection by S. commune is possible in immunocompetent patients.
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KEYWORD
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Schizophyllum commune, Bronchiectasis, Immunocompetence
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