Pathology

A 33-year-old man suddenly develops severe dyspnea with wheezing. On physical examination, his vital signs are temperature, 37deg C; pulse, 95/min; respirations, 35/min; and blood pressure, 130/80 mm Hg. A chest radiograph shows increased lucency in all lung fields. Arterial blood gas analysis shows PO2, 65 mm Hg; PCO2, 30 mm Hg; and pH, 7.48. A sputum cytologic specimen shows Curschmann spirals, Charcot-Leyden crystals, branching septate hyphae, and eosinophils in a background of abundant mucus. What is the most likely risk factor predisposing him to this illness?