Hypersensitivity Pneumonitis Caused by a Home Ultrasonic Humidifier Contaminated with Candida guilliermondii.

Published on Nov 15, 2017in Internal Medicine1.005
· DOI :10.2169/INTERNALMEDICINE.9055-17
Akemi Ando2
Estimated H-index: 2
(Okayama University),
Hideharu Hagiya13
Estimated H-index: 13
(Osaka University)
+ 5 AuthorsFumio Otsuka35
Estimated H-index: 35
(Okayama University)
Sources
Abstract
: We herein report the first documented case of acute hypersensitivity pneumonitis in which Candida guilliermondii was the possible causative organism. A young Japanese woman presented to our hospital with relapsing respiratory symptoms accompanied by high fever. A detailed interview revealed that the onset of the symptoms occurred shortly after using a humidifier in her home. Her symptoms showed spontaneous improvement soon after admission, and an examination of her bronchoalveolar lavage fluid revealed the specific infiltration of inflammatory cells, which predominantly consisted of lymphocytes. Precipitin testing showed a positive reaction to C. guilliermondii, which was isolated from the home humidifier. Repeated history taking is essential for diagnosing occult respiratory disorders.
References21
Newest
#1Santiago Quirce (Ciber)H-Index: 65
#2Olivier Vandenplas (UCL: Université catholique de Louvain)H-Index: 46
Last. Y. Cormier (Laval University)H-Index: 2
view all 14 authors...
The aim of this document was to provide a critical review of the current knowledge on hypersensitivity pneumonitis caused by the occupational environment and to propose practical guidance for the diagnosis and management of this condition. Occupational hypersensitivity pneumonitis (OHP) is an immunologic lung disease resulting from lymphocytic and frequently granulomatous inflammation of the peripheral airways, alveoli, and surrounding interstitial tissue which develops as the result of a non-Ig...
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#1Masahiro Ishizuka (Tokyo Medical and Dental University)H-Index: 6
#2Yasunari MiyazakiH-Index: 22
Last. Naohiko InaseH-Index: 27
view all 6 authors...
Rationale: Hypersensitivity pneumonitis (HP) is an immunologically mediated lung disease induced by the inhalation of any of a wide variety of antigens. For example, bird-related HP (BRHP) results from the inhalation of avian antigens. The clinical features of chronic HP, including imaging and histological findings, are similar to those of idiopathic pulmonary fibrosis. Despite its status as the “gold standard,” the inhalation provocation test (IPT) is rarely performed, because the methods and t...
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#1Reto Crameri (Swiss Institute of Allergy and Asthma Research)H-Index: 75
#2Mattia Garbani (Swiss Institute of Allergy and Asthma Research)H-Index: 6
Last. C. Huitema (Swiss Institute of Allergy and Asthma Research)H-Index: 1
view all 4 authors...
Allergic diseases are considered the epidemics of the twentieth century estimated to affect more than 30% of the population in industrialized countries with a still increasing incidence. During the past two decades, the application of molecular biology allowed cloning, production and characterization of hundreds of recombinant allergens. In turn, knowledge about molecular, chemical and biologically relevant allergens contributed to increase our understanding of the mechanisms underlying IgE-medi...
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#1Vincenzo SaviniH-Index: 17
#2Chiara CatavitelloH-Index: 13
Last. Domenico D'AntonioH-Index: 28
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Summary Candida guilliermondii is an uncommon isolate throughout most of the world, the behaviour of which as an environmental fungus, a human saprophyte and an agent of serious infections has been emphasised over the years. Notably, illnesses caused by this pathogen mostly involve compromised cancer hosts and commonly lead patients to unfavourable outcomes. It is of concern that the yeast may acquire or inherently express reduced in vitro sensitivity to all antifungal classes, although widespre...
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Purpose:The purpose of this study was to evaluate serial changes and the prognostic value of high-resolution computed tomographic (HRCT) findings in hypersensitivity pneumonitis (HP).Method:The medical records of 112 patients with bird-related HP (17 acute, 33 recurrent, and 62 insidious) were retro
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#1Carlos SerranoH-Index: 10
#2Alfonso TorregoH-Index: 12
Last. César PicadoH-Index: 63
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Abstract Hypersensitivity pneumonitis (HP) is a lung disease caused by heavy and recurrent inhalation of antigens. We describe the case of a patient with HP caused by domestic exposure to Candida spp. The diagnosis was made by taking into consideration the clinical presentation, exposure history, radiological findings, bronchoalveolar lavage, lung function and the immuno-allergy study. The diagnosis was definitively confirmed by performing a specific bronchial provocation test. It has been shown...
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#1Carlos SerranoH-Index: 2
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#1M. Girard (Laval University)H-Index: 1
#2Y. Lacasse and (Laval University)H-Index: 1
Last. Y. Cormier (Laval University)H-Index: 2
view all 3 authors...
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#1Ferran Morell (Autonomous University of Barcelona)H-Index: 48
#2Àlex RogerH-Index: 6
Last. Xavier MuñozH-Index: 30
view all 6 authors...
Abstract:Bird fancier's lung (BFL) is one of the most common types of hypersensitivity pneumonitis. Nevertheless, the criteria for diagnosing this condition are not standardized. The current study is an in-depth investigation into the clinical characteristics of BFL in the largest series examined fo
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#1Masoud Solaymani-Dodaran (Nottingham City Hospital)H-Index: 23
#2Joe West (Nottingham City Hospital)H-Index: 72
Last. Richard Hubbard (Nottingham City Hospital)H-Index: 94
view all 4 authors...
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