BRONCHIAL MUCOID IMPACTION DUE TO THE MONOKARYOTIC MYCELIUM OF SCHIZOPHYLLUM-COMMUNE

We report, to our knowledge, the first case of mucoid impaction of the bronchi due to a hypersensitivity reaction to the monokaryotic myceli um of Schizophyllum commune. The patient was hospitalized because of m ild asthma attacks, persistent cough, peripheral eosinophilia, and ''g loved finger'' shadows on a chest roentgenogram. Bronchoscopic examina tion disclosed mucoid impactions that consisted of accumulations of eo sinophils, Charcot-Leyden crystals, and nondichotomously branched hyph ae in B-3, B-9, and B-10 of the left lung. Cultures of the mucous plug s and sputum samples yielded white, felt-like mycelial colonies that w ere 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 c ytosol antigen were positive. Repeated bronchoscopies for performing b ronchial toilet were effective in removing the mucous plugs and reliev ing 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.