The interstitial lung illness known as hypersensitivity pneumonia is characterised by an aberrant immune response to certain antigens found in a variety of organic particles like dust. Hypersensitivity pneumonia at least in Japan according to research [1] is of the summer-type hypersensitivity pneumonia (hypersensitivity pneumonia). Trichosporon cutaneum inhalation is the main cause of hypersensitivity pneumonia which grows mainly after the rainy season when conditions are warm and humid and then cause issues in the summertime. But there are other fungi like Fusarium and Penicillium that are also known to cause hypersensitivity pneumonia.
The following is a summary of the clinical findings for a patient that is the subject of this research.
It is an instructive publication since it touches on the symptomology and clinical presentation of mould illness. The reason this paper is of significance is that the triggering fungus is an environmental fungus. This means it is ubiquitous in the environment and not usually implicated in acute disease like other micro-organisms that cause for example sepsis or food poisoning.
Clinical Findings:
• On March 29, 2006, a 75-year-old man was taken to Kanazawa University Hospital with dyspnea, a strong cough, a fever, and wheezing. Diagnostic imaging using radiographs and computed tomography showed considerable damage.
• Following a physical test, the following results were found: temperature 38.6, blood pressure of 90/58 mmHg, and pulse rate of 84 beats, breathing rate was 26 times per minute.
• The patient's symptoms and steadily improved, and on April 7 he was released.
• He was readmitted 3 days later due to coughing, wheezing, and dyspnea that had returned.
• Sterile petri plates were used to test his house by putting them on the floor of every room. These collected air samples using the settle plate technique. In this way the indoor air quality and mycobiome could be measured. This is the same approach you can use to test your own home or workplace for environmental fungi.
• After the Petri plates were cultured, the dominant moulds were: Aspergillus fumigatus and Bjerkandera adusta.
Fungal antigen skin tests were performed, however neither the immediate-type nor the late-type reactions for A. fumigatus and B. adusta were positive. Only the particular Aspergillus IgE was found to be positive. After the patient provided informed consent, a different test known as the Bronchoprovocation test was carried out using 2 ml of the fungal antigen solutions (1 mg! ml). Inhaling the A. fumigatus antigen resulted in wheezing, and inhaling the B. adusta antigen did the same.
Why is this important?
One of the most significant antigens for hypersensitivity pneumonia is fungi.
The main antigen connected to summer-type hypersensitivity pneumonia is T. cutaneum. A common white rot saprophyte fungus called B. adusta is a filamentous basidiomycetes fungus found in fields and mountains where it primarily grows on dead trees. The patient's residence was where B. adusta was found. Testing the home with petri plates returned a positive result and then when patient returned, the inhalation bronchoprovocation test was positive for B. adusta antigen. These facts served as convincing evidence in the matter at hand. These results led to the diagnosis of hypersensitivity pneumonia caused by the B. adusta antigen, which the patient was effectively treated for.
If you are concerned about fungi in your home, then test your home today with one of our kits. Hopefully your indoor air quality will be good, but if it isn't then you can do something about it.
REFERENCE:
1. Katayama N, Fujimura M, Yasui M, Ogawa H, Nakao S. Hypersensitivity pneumonitis and bronchial asthma attacks caused by environmental fungi. Allergol Int. 2008 Sep;57(3):277-80. doi: 10.2332/allergolint.C-07-56. Epub 2008 Jun 1. PMID: 18493169. https://pubmed.ncbi.nlm.nih.gov/18493169/