We read with interest the study by Ozyigit et al. wherein the authors describe fungal bronchitis as a distinct clinical entity that responds to antifungal therapy.¹ The authors define “bronchitis” based on persistent productive cough and exacerbation of underlying airway disease. The same definition is also applicable to bronchiectasis, a widely recognized entity. Notably, 24 of the 31 study participants had bronchiectasis, which explains the symptoms attributed to “bronchitis”. Further, the mean serum Aspergillus fumigatus-specific IgE, A. fumigatus-specific IgG levels, and total IgE were 19.4 KUA/L, 54.3 mg/L, and 2.121 U/L, respectively, in the study population. The majority of the subjects in the study had asthma as their underlying airway disease. The constellation of asthma, elevated serum total IgE, A. fumigatus-specific IgE, and IgG, and bronchiectasis is consistent with allergic bronchopulmonary aspergillosis (ABPA). It would be interesting to know what proportion of patients in the current study satisfied the International Society for Human and Animal Mycology (ISHAM) ABPA-working group criteria for diagnosing ABPA.² Two different randomized controlled trials have demonstrated that oral triazoles are beneficial in treating ABPA.^3,4 It is therefore not surprising that patients with “fungal bronchitis” responded to azoles in the current study.

中文翻译：

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真菌性支气管炎或过敏性支气管肺曲霉病……这是个问题

我们饶有兴趣地阅读了 Ozyigit 等人的研究。其中作者将真菌性支气管炎描述为对抗真菌治疗有反应的独特临床实体。¹作者根据持续的咳痰和潜在气道疾病的恶化来定义“支气管炎”。相同的定义也适用于广泛认可的支气管扩张症。值得注意的是，31 名研究参与者中有 24 名患有支气管扩张，这解释了归因于“支气管炎”的症状。此外，平均血清烟曲霉特异性 IgE、烟曲霉在研究人群中，特异性 IgG 水平和总 IgE 分别为 19.4 KUA/L、54.3 mg/L 和 2.121 U/L。研究中的大多数受试者患有哮喘作为他们的潜在气道疾病。哮喘、血清总 IgE 升高、烟曲霉特异性 IgE 和 IgG 以及支气管扩张与过敏性支气管肺曲霉病 (ABPA) 一致。了解当前研究中满足国际人类和动物真菌学学会 (ISHAM) ABPA 工作组诊断 ABPA 标准的患者比例会很有趣。²两项不同的随机对照试验表明，口服三唑类药物对治疗 ABPA 有益。^3,4 因此，在目前的研究中，“真菌性支气管炎”患者对唑类有反应也就不足为奇了。