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Hypersensitivity Pneumonitis From Fire-Retardant Spray in a Patient With Multiple Lung Pathologies and Elevated Immunoglobulin E
Background: Hypersensitivity pneumonitis, also known as extrinsic allergic alveolitis, is a pulmonary disease with large knowledge gaps, including etiology, pathogenesis, diagnosis, and treatment. Case Report: A 58-year-old male with a pertinent history of recurrent Mycobacterium malmoense presented...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Academic Division of Ochsner Clinic Foundation
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8675614/ https://www.ncbi.nlm.nih.gov/pubmed/34984061 http://dx.doi.org/10.31486/toj.20.0163 |
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author | Prasad, Rohan Madhu Kemnic, Tyler Al-Abcha, Abdullah Sharma, Akhil Kavuturu, Shilpa |
author_facet | Prasad, Rohan Madhu Kemnic, Tyler Al-Abcha, Abdullah Sharma, Akhil Kavuturu, Shilpa |
author_sort | Prasad, Rohan Madhu |
collection | PubMed |
description | Background: Hypersensitivity pneumonitis, also known as extrinsic allergic alveolitis, is a pulmonary disease with large knowledge gaps, including etiology, pathogenesis, diagnosis, and treatment. Case Report: A 58-year-old male with a pertinent history of recurrent Mycobacterium malmoense presented to a tertiary emergency department after 1 week of difficulty breathing. He also reported a productive cough and fevers. The patient was an active smoker and was recently exposed to chemical fire-retardant spray. Chest x-ray showed extensive bilateral pulmonary infiltrates. The tertiary center initiated cefpodoxime 200 mg twice daily for 5 days and home azithromycin for possible pneumonia. However, the patient returned the next day with worsening symptoms. After the patient transferred to our institution, physical examination revealed a hypoxic patient with bibasilar crackles and wheezes. Laboratory tests revealed elevated white blood cell count, sedimentation rate, and immunoglobulin E. Chest computed tomography demonstrated growth of a previously noted right upper lobe intracavitary lesion and new onset diffuse interstitial pulmonary ground-glass airspace opacities. Hypersensitivity pneumonitis panel demonstrated positive antibodies to Aspergillus fumigatus antibody precipitin 1 and Micropolyspora faeni. The patient was given oral prednisone and advice on proper respiratory precautions in the workplace. Conclusion: This case illustrates that hypersensitivity pneumonitis can develop via chemical fire-retardant spray. Additionally, patients with a smoking history and elevated immunoglobulin E should be evaluated for severe forms of the disease. |
format | Online Article Text |
id | pubmed-8675614 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Academic Division of Ochsner Clinic Foundation |
record_format | MEDLINE/PubMed |
spelling | pubmed-86756142022-01-03 Hypersensitivity Pneumonitis From Fire-Retardant Spray in a Patient With Multiple Lung Pathologies and Elevated Immunoglobulin E Prasad, Rohan Madhu Kemnic, Tyler Al-Abcha, Abdullah Sharma, Akhil Kavuturu, Shilpa Ochsner J Case Reports and Clinical Observations Background: Hypersensitivity pneumonitis, also known as extrinsic allergic alveolitis, is a pulmonary disease with large knowledge gaps, including etiology, pathogenesis, diagnosis, and treatment. Case Report: A 58-year-old male with a pertinent history of recurrent Mycobacterium malmoense presented to a tertiary emergency department after 1 week of difficulty breathing. He also reported a productive cough and fevers. The patient was an active smoker and was recently exposed to chemical fire-retardant spray. Chest x-ray showed extensive bilateral pulmonary infiltrates. The tertiary center initiated cefpodoxime 200 mg twice daily for 5 days and home azithromycin for possible pneumonia. However, the patient returned the next day with worsening symptoms. After the patient transferred to our institution, physical examination revealed a hypoxic patient with bibasilar crackles and wheezes. Laboratory tests revealed elevated white blood cell count, sedimentation rate, and immunoglobulin E. Chest computed tomography demonstrated growth of a previously noted right upper lobe intracavitary lesion and new onset diffuse interstitial pulmonary ground-glass airspace opacities. Hypersensitivity pneumonitis panel demonstrated positive antibodies to Aspergillus fumigatus antibody precipitin 1 and Micropolyspora faeni. The patient was given oral prednisone and advice on proper respiratory precautions in the workplace. Conclusion: This case illustrates that hypersensitivity pneumonitis can develop via chemical fire-retardant spray. Additionally, patients with a smoking history and elevated immunoglobulin E should be evaluated for severe forms of the disease. Academic Division of Ochsner Clinic Foundation 2021 2021 /pmc/articles/PMC8675614/ /pubmed/34984061 http://dx.doi.org/10.31486/toj.20.0163 Text en ©2021 by the author(s); Creative Commons Attribution License (CC BY) https://creativecommons.org/licenses/by/4.0/©2021 by the author(s); licensee Ochsner Journal, Ochsner Clinic Foundation, New Orleans, LA. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (creativecommons.org/licenses/by/4.0/legalcode) that permits unrestricted use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. |
spellingShingle | Case Reports and Clinical Observations Prasad, Rohan Madhu Kemnic, Tyler Al-Abcha, Abdullah Sharma, Akhil Kavuturu, Shilpa Hypersensitivity Pneumonitis From Fire-Retardant Spray in a Patient With Multiple Lung Pathologies and Elevated Immunoglobulin E |
title | Hypersensitivity Pneumonitis From Fire-Retardant Spray in a Patient With Multiple Lung Pathologies and Elevated Immunoglobulin E |
title_full | Hypersensitivity Pneumonitis From Fire-Retardant Spray in a Patient With Multiple Lung Pathologies and Elevated Immunoglobulin E |
title_fullStr | Hypersensitivity Pneumonitis From Fire-Retardant Spray in a Patient With Multiple Lung Pathologies and Elevated Immunoglobulin E |
title_full_unstemmed | Hypersensitivity Pneumonitis From Fire-Retardant Spray in a Patient With Multiple Lung Pathologies and Elevated Immunoglobulin E |
title_short | Hypersensitivity Pneumonitis From Fire-Retardant Spray in a Patient With Multiple Lung Pathologies and Elevated Immunoglobulin E |
title_sort | hypersensitivity pneumonitis from fire-retardant spray in a patient with multiple lung pathologies and elevated immunoglobulin e |
topic | Case Reports and Clinical Observations |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8675614/ https://www.ncbi.nlm.nih.gov/pubmed/34984061 http://dx.doi.org/10.31486/toj.20.0163 |
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