Fungal contamination of a residence: possible association with hypersensitivity pneumonitis.
Lewis DM; Kotimaa M; Petsonk EL; Short SR; Sorenson WG
Sixth US-Finnish Joint Symposium on Occupational Health and Safety, People and Work, Proceedings of the Sixth FIOH-NIOSH Joint Symposium on Occupational Health and Safety, August 8-10, 1995, Espoo, Finland. People and Work - Research Reports 3. H. Nordman, J. Starck, A. Tossavainen, E. Viikari-Juntura, eds. Helsinki, Finland: Finnish Institute of Occupational Health; 1995 Aug; :114-118
A case of hypersensitivity pneumonitis (HP) possibly associated with fungal contamination of the patient's home was examined. A 55 year old male was evaluated for a febrile illness characterized by night sweats, headache, and dyspnea. His symptoms improved after corticosteroid treatment. He was seen by a pulmonary specialist 16 months later for recurrent episodes of dyspnea and fever. A serological evaluation for HP associated organisms found high titers of antibodies raised against Aspergillus species. Based on this, the patient was diagnosed with HP. His dyspnea worsened over the next year. He lived in a 200 year old farm house and noted that his dyspnea improved when he took a 1 month vacation away from the house. Because of this, he built and moved into a new house. Before the farm house was torn down, a NIOSH environmental evaluation was performed. Environmental samples were collected and analyzed for fungal species. Blood samples were also collected from the patient when he was asymptomatic. The serum was separated and analyzed for immunoglobulin-G (IgG) antibodies to fungi identified in the environmental samples. Total fungal levels in the indoor air of the house averaged ten times higher than in the outside air. The four most predominant fungal species identified in the indoor air were two Aspergillus species and one each of Penicillium and Paecilomyces. Twenty one different fungal species were detected in swab and scrape samples. Sera from the patient contained detectable IgG antibodies to 14 of these. Wallemia-sebi and Penicillium- glabrum were the two most predominant species detected. The authors conclude that the environmental and serological data suggest but do not prove that fungal contamination of the patient's residence could have contributed to his developing HP.
Respiratory-hypersensitivity; Case-studies; Immunoglobulins; Microorganisms; Indoor-air-pollution; Antibody-response; Clinical-symptoms; Respiratory-system-disorders; Environmental-exposure; Indoor-environmental-quality
Nordman H; Starck J; Tossavainen A; Viikari-Juntura E
Sixth US-Finnish Joint Symposium on Occupational Health and Safety, People and Work, Proceedings of the Sixth FIOH-NIOSH Joint Symposium on Occupational Health and Safety, 8-10 August 1995, Espoo, Finland. People and Work - Research Reports 3