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

A female patient in her thirties presented with persistent cough and sputum, unresponsive to conventional treatments. Chest imaging showed infiltrative opacities and high attenuation mucus. On laboratory examination, eosinophil counts and immunoglobulin E were elevated. Cordyceps farinosa, a species of caterpillar fungi, was identified by bronchoscopy and subsequent DNA sequencing from the mucus plug. The symptoms improved after the removal of mucus plugs and cessation of exposure to the work environment. Allergic bronchopulmonary mycosis (ABPM) caused by C. farinosa has not been reported, and its pathogenicity is not well recognized. Herein, we report this case to understand the disease spectrum of ABPM and the pathogenicity of this rare fungi.