ABSTRACT
Las neumonitis por hipersensibilidad (NH) pueden producirse debido a la exposición a hongos ambientales por contaminación de humidificadores y sistemas de calefacción. Describimos el caso de una paciente que acudió a urgencias por disnea, tos, dolor torácico y fiebre. Presentaba infiltrados intersticiales en la radiografía de tórax y leucocitosis con neutrofilia e hipoxemia grave en la analítica sanguínea. La combinación de exploraciones clínicas, radiológicas, fisiológicas e inmunológicas llevó al diagnóstico de NH. Tenía un humidificador doméstico en casa desde hacía un año. En el cultivo de las muestras de agua del humidificador crecióTrichoderma viride. Se detectaron anticuerpos precipitantes inmunoglobulina G anti T. viride mediante enzimoinmunoanálisis en el suero de la paciente. Tras retirar el humidificador la paciente permaneció asintomática. El resultado de los estudios indica que desarrolló NH causada por T. viride que contaminaba el agua del humidificador. Según nuestro conocimiento, éste es el primer caso descrito de NH por T. viride(AU)
Hypersensitivity pneumonitis (HP) can be induced by exposure to indoor molds contaminating humidifiers and heating or ventilation systems. A 54-year-old woman with dyspnea, cough, chest pain, and fever was seen in the emergency room. A chest radiograph revealed interstitial infiltrates and blood tests showed leukocytosis with neutrophilia and severe hypoxemia. A diagnosis of HP was made by a combination of clinical, radiologic, physiologic, and immunologic studies. Trichoderma viride was isolated in cultures of water samples from an ultrasonic humidifier installed in the patient's home a year earlier. Precipitating immunoglobulin G antibodies to T viride were detected in the patient's serum by enzyme-linked immunosorbent assay. The patient remained symptom free after the humidifier was removed from her home. Our findings strongly suggest that the patient developed HP due to T viride from the humidifier. To our knowledge, this is the first report of such a case(AU)
Subject(s)
Humans , Female , Middle Aged , Alveolitis, Extrinsic Allergic/complications , Alveolitis, Extrinsic Allergic/diagnosis , Trichoderma/virology , Trichoderma/pathogenicity , Trichoderma/isolation & purification , Equipment Contamination , Air Conditioning/instrumentation , Dyspnea , FungiABSTRACT
Hypersensitivity pneumonitis (HP) can be induced by exposure to indoor molds contaminating humidifiers and heating or ventilation systems. A 54-year-old woman with dyspnea, cough, chest pain, and fever was seen in the emergency room. A chest radiograph revealed interstitial infiltrates and blood tests showed leukocytosis with neutrophilia and severe hypoxemia. A diagnosis of HP was made by a combination of clinical, radiologic, physiologic, and immunologic studies. Trichoderma viride was isolated in cultures of water samples from an ultrasonic humidifier installed in the patient's home a year earlier. Precipitating immunoglobulin G antibodies to T viride were detected in the patient's serum by enzyme-linked immunosorbent assay. The patient remained symptom free after the humidifier was removed from her home. Our findings strongly suggest that the patient developed HP due to T viride from the humidifier. To our knowledge, this is the first report of such a case.
