Hypersensitivity pneumonitis of a bagpipe player: Fungal antigens as trigger?

Katharina Ziegler; Marcus Joest; Nesrin Turan; Dirk Schmidt; Peter-Michael Rath; Joerg Steinmann

doi:10.1016/j.mmcr.2019.03.005

Medical Mycology Case Reports (Jun 2019)

Hypersensitivity pneumonitis of a bagpipe player: Fungal antigens as trigger?

Katharina Ziegler,
Marcus Joest,
Nesrin Turan,
Dirk Schmidt,
Peter-Michael Rath,
Joerg Steinmann

Affiliations

Katharina Ziegler: Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Paracelsus Medical University, Prof.-Ernst-Nathan Straße 1, 90419 Nuremberg, Germany; Corresponding author.
Marcus Joest: Allergologic-Immunologic Laboratory, Malteser Lung- and Allergy Center Bonn, Weberstraße 118, 53113 Bonn, Germany
Nesrin Turan: Clinic of Internal Medicine 3, Department of Pneumology, Paracelsus Medical University, Prof.-Ernst-Nathan Straße 1, 90419 Nuremberg, Germany
Dirk Schmidt: Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstraße 55, 45122 Essen, Germany
Peter-Michael Rath: Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstraße 55, 45122 Essen, Germany
Joerg Steinmann: Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Paracelsus Medical University, Prof.-Ernst-Nathan Straße 1, 90419 Nuremberg, Germany

DOI: https://doi.org/10.1016/j.mmcr.2019.03.005
Journal volume & issue: Vol. 24
pp. 44 – 47

Abstract

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Here we present a 79-year old man with chronic hypersensitivity pneumonitis probably caused by fungal contamination of a bagpipe. Several samples were taken from the patient's bagpipe. Four potential fungal antigens (Exophiala phaeomuriformis, Kwoniella europaea, Pyrenochaeta unguis-hominis and Aureobasidium melanogenum) as potential trigger of hypersensitivity pneumonitis were identified. A serum ELISA test with Exophiala phaeomuriformis indicated reactivity.Cessation of playing the bagpipe and application of glucocorticoids lead to an improvement of the patient's symptoms. Keywords: Hypersensitivity pneumonitis, Bagpipe, Fungal antigens, Serological testing

Published in Medical Mycology Case Reports

ISSN: 2211-7539 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Medicine (General); Science: Biology (General)
Website: https://www.journals.elsevier.com/medical-mycology-case-reports/

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