Author/Editor		Marin, Aleksander; Mušič, Ema; Eržen, Renato; Uršič, Viktor; Korošec, Peter
Title		Extrinsic allergic alveolitis from the bedroom
Type		članek
Source		Allergo-J
Vol. and No.		Letnik 18, št. 6
Publication year		2009
Volume		str. 438-43
Language		eng
Abstract		Case report: In the summer of 2007, a 49-year-old Caucasian woman (nonsmoker, receptionist) was admitted to our hospital four times with symptoms of fever, dry cough, and inspiratory crackles over the lung bases. At every admission we noted blood leukocytosis. Chest high-resolution computed tomography revealed interstitial thickening with groundglass opacities mostly on the lung bases. A few days after in-hospital antibiotic therapy, high blood leukocytosis and clinical symptoms disappeared. Lung function tests showed normal ventilation and slightly decreased lung diffusion capacity. Bronchoscopy revealed signs of diffuse vulnerable bronchial mucosa.The bronchoalveolar lavage fluid revealed lymphocytic alveolitis with a CD4+/CD8+ ratio of 10.43, an atypical finding in extrinsic allergic alveolitis (EAA). Transbronchial lung biopsy showed nonspe cific focal interstitial inflammation with formation of granulomas. Available routine tests for precipitating antibodies in the serum were negative. A case history was repeatedly taken, especially regarding home and occupational environment. Information about the moist wall area in the patient's bedroom was crucial, but did not seem to be significant to the patient before. The fungus Cladosporium sphaerospermum, one of the most common air-borne cosmopolitan Cladosporium species, was isolated from the bedroom wall. After a bedroom change and attempts at removing the moisture from the bedroom walls, the symptoms of EAA disappeared without any drug therapy and lung function normalized. Conclusion: Acute EAA is an underdiagnosed entity requiring detailed and case oriented environmenral and occupational history.
Descriptors		ALVEOLITIS, EXTRINSIC ALLERGIC AIR POLLUTION, INDOOR CLADOSPORIUM