title: Two cases of Schizophyllum asthma: is this a new clinical entity or a precursor of ABPM?
abstract: BACKGROUND
  There is a close link between fungal sensitization and asthma severity. Although Schizophyllum commune (S. commune, "suehirotake" in Japanese), one of the basidiomycetous (BM) fungi, is a fungus that can cause allergic bronchopulmonary mycosis (ABPM) and allergic fungal sinusitis (AFS), whether the fungus causes or sensitizes subjects to asthma is unclear.
  
  
  METHODS
  The bronchial provocation test using S. commune antigen was performed in two asthmatics who had demonstrated positive skin reactions to the S. commune antigen, and low dose of itraconazole (50 mg/day) was prescribed as an adjunctive therapy for 2 weeks. The allergological features and clinical manifestations of these patients are herein evaluated and discussed.
  
  
  RESULTS
  Case 1 was a 71-year-old female, and case 2 was a 69-year-old male. Both patients demonstrated positive reactions to the inhalation test. A diagnosis of AFS or ABPM was excluded in both patients because of the lack of a history of pulmonary infiltrates, central bronchiectasis, a history of expectoration of brown plugs or flecks, or sinusoidal findings. Although the efficacy of itraconazole in our cases was unclear, the elevated titer of the specific IgG-for S. commune in case 2 gradually decreased during the period of antifungal therapy.
  
  
  CONCLUSIONS
  The two patients described herein were diagnosed to have bronchial asthma caused by S. commune; so-called Schizophyllum asthma. S. commune may also be a causative fungal antigen of bronchial asthma.
authors.affiliation: Division of Pulmonary Medicine, Ishikawa-ken Saiseikai Kanazawa Hospital, Ni-13-6 Akatsuchi-machi, Kanazawa, Japan. saiseikh@po3.nsknet.or.jp
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Ogawa
authors.forename: Masaki
authors.initials: M
authors.lastname: Fujimura
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Takeuchi
authors.forename: Koichi
authors.initials: K
authors.lastname: Makimura
mesh_terms: D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use; D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D001985:Bronchial Provocation Tests; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology; D055744:Invasive Pulmonary Aspergillosis / Q000175:diagnosis / Q000382:microbiology*; D017964:Itraconazole / Q000627:therapeutic use; D008297:Male; D012567:Schizophyllum / Q000276:immunology / Q000302:isolation & purification*; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents; D007074:Immunoglobulin G; D017964:Itraconazole