Successful treatment by switching from benralizumab to dupilumab in a patient with allergic bronchopulmonary mycosis caused by Schizophyllum commune

Abstract

A 79-year-old female patient with a history of bronchial asthma was diagnosed with allergic bronchopulmonary aspergillosis. Her symptoms temporarily improved with inhaled corticosteroid/long-acting β2-agonist therapy. However, 10 months after treatment, her asthma symptoms worsened. Sputum culture showed white cotton wool colonies, which were identified as Schizophyllum commune via matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and gene sequencing. The patient tested positive for S. commune-specific IgG. Thus, she was diagnosed with Schizophyllum commune-induced allergic bronchopulmonary mycosis. The patient was initially treated with benralizumab. However, it was not effective. After switching to dupilumab, her symptoms and mucus plugs improved.