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A Case of Allergic Bronchopulmonary Mycosis Caused by Cordyceps farinosa, a Species of Caterpillar Fungi

Summary

A woman developed a serious respiratory condition called allergic bronchopulmonary mycosis caused by Cordyceps farinosa, a fungus that normally infects insect larvae. She worked in a laboratory breeding mice in a mountainous area and developed persistent cough and congestion. Doctors identified the fungus using DNA testing and treated her by removing the fungal material from her airways and removing her from the workplace, which led to complete recovery.

Background

Allergic bronchopulmonary mycosis (ABPM) is a hypersensitivity-mediated disease caused by environmental fungi colonization of the lower respiratory tract. While ABPM caused by Aspergillus species is most common, cases caused by non-Aspergillus fungi like Schizophyllum commune are increasing. However, ABPM caused by Cordyceps farinosa has not been previously reported.

Objective

To report the first documented case of ABPM caused by Cordyceps farinosa and demonstrate the pathogenicity of this caterpillar fungus in humans. This case aims to expand understanding of the disease spectrum of ABPM and the clinical significance of rare fungal pathogens.

Results

Cordyceps farinosa was identified from the mucus plug obtained during bronchoscopy through DNA sequencing. The patient met six diagnostic criteria for ABPM including peripheral eosinophilia, elevated IgE, central bronchiectasis, mucus plugs, and high attenuation mucus on CT. Symptoms resolved after mucus plug removal and cessation of workplace exposure.

Conclusion

This is the first reported case of ABPM caused by Cordyceps farinosa, demonstrating the pathogenicity of this fungus to humans. The case highlights the importance of DNA sequencing for identifying rare causative fungi in ABPM and the effectiveness of environmental isolation combined with mechanical removal of fungal plugs as a treatment approach.
  • Published in:Cureus,
  • Study Type:Case Report,
  • Source: PMID: 39355473
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