Schizophyllum commune is one of most widely distributed fungal species, often found on dead and decaying organic matter. Only a few cases of S. commune infections in immunocompetent patients, including the sinus, sino-orbital, bronchopulmonary, and extra-pulmonary areas have been reported. A 52-year-old female patient presented with symptoms of cough, whitish sputum, and chest discomfort lasting approximately one month. The patient denied any relevant medical history. Chest radiography revealed a mass-like consolidation at the right lower lobe. Bronchoscopy showed thick, white-yellowish mucoid plugs on several bronchi on the right middle lobe. Transbronchial biopsy and aspiration were performed. Gomori's methenamine silver staining on a prepared paraffin block and fungal culture revealed a few scattered degenerated fungal hyphae. DNA amplification and sequencing analysis of the Internal Transcribed Spacer gene demonstrated 100% identity with S. commune; access number MK029865.1. The patient was diagnosed with bronchiectasis with mucoid impaction caused by S. commune fungal infection and recovered fully after 4 weeks of oral administration of itraconazole 200 mg twice a day. In Korea, there have been only two cases of fungal infections caused by S. commune in immunocompetent patients. The cases were allergic fungal sinusitis and sino-orbital infection. This report provides additional evidence that invasive fungal infection by S. commune is possible in immunocompetent patients.
In general, biotin supplementation is rarely necessary, except for the treatment of metabolic disorders, such as propionic acidemia, biotinidase de ciency, and multiple sclerosis. Recently, in addition to medical indications, biotin intake increased for esthetic indications, such as hair growth, skin health, and nail strength [3]. In the US, the market size for vitamin and mineral supplements is over $30 billion annually [3]. In Korea, the consumption of dietary supplements is growing, and the most frequently consumed dietary supplements are multivitamin mineral supplements, with a prevalence rate of 89.6 per 1,000 persons [4]. According to the 2020 data from the Ministry of Food and Drug Safety (Korea), the top five companies earned approximately $1.1 million from biotin sales alone [5].There are signi cant differences in biotin levels in the general population from country to country. According to some studies, 0%-7.4% of patients' samples contain biotin levels above 10 ng/ mL: the lowest threshold for biotin interference [6][7][8][9][10]. Nonetheless, serum biotin levels have never been evaluated in Koreans. In Biotin is a water-soluble vitamin that is an essential coenzyme for multiple metabolic processes in the human body [1]. In immunoassays, streptavidin-biotin binding is widely used due to its strong af nity. Therefore, increased serum biotin levels can interfere with immunoassays, thereby leading to serious medical problems. Indeed, the United States (US) Food and Drug Administration (FDA) released a safety communication about the potential 한국인에서 혈청 비오틴 농도
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