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

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

Med Mycol Case Rep. 2019 Mar 26:24:44-47. doi: 10.1016/j.mmcr.2019.03.005. eCollection 2019 Jun.

Authors

Katharina Ziegler¹, Marcus Joest², Nesrin Turan³, Dirk Schmidt⁴, Peter-Michael Rath⁴, Joerg Steinmann¹

Affiliations

¹ Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Paracelsus Medical University, Prof.-Ernst-Nathan Straße 1, 90419 Nuremberg, Germany.
² Allergologic-Immunologic Laboratory, Malteser Lung- and Allergy Center Bonn, Weberstraße 118, 53113 Bonn, Germany.
³ Clinic of Internal Medicine 3, Department of Pneumology, Paracelsus Medical University, Prof.-Ernst-Nathan Straße 1, 90419 Nuremberg, Germany.
⁴ Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstraße 55, 45122 Essen, Germany.

Abstract

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: Bagpipe; Fungal antigens; Hypersensitivity pneumonitis; Serological testing.

Publication types

Case Reports