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[Hypersensitivity pneumonitis caused by Trichoderma viride].

Alicia Enríquez-Matas1, Santiago Quirce, Noelia Cubero

  • 1Departamento de Alergia, Fundación Jiménez Díaz, Madrid, España. aenriquezmatas@hotmail.com

Archivos De Bronconeumologia
|May 16, 2009
PubMed
Summary

This case report identifies Trichoderma viride mold in a humidifier as the cause of hypersensitivity pneumonitis (HP). Removing the contaminated humidifier resolved the patient's severe respiratory symptoms.

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Area of Science:

  • Environmental Medicine
  • Pulmonary Medicine
  • Mycology

Background:

  • Hypersensitivity pneumonitis (HP) is a lung disease often caused by inhaling environmental antigens, including molds.
  • Indoor molds in humidifiers and HVAC systems are recognized sources of exposure.
  • Prompt diagnosis and antigen identification are crucial for effective management.

Observation:

  • A 54-year-old woman presented with acute respiratory symptoms including dyspnea, cough, chest pain, and fever.
  • Radiographic findings showed interstitial infiltrates, and laboratory tests revealed leukocytosis and severe hypoxemia.
  • Trichoderma viride was identified in water from the patient's ultrasonic humidifier.

Findings:

  • Clinical, radiologic, and immunologic evaluations confirmed a diagnosis of hypersensitivity pneumonitis.
  • Enzyme-linked immunosorbent assay detected specific IgG antibodies to T. viride in the patient's serum.
  • Complete symptom resolution occurred after the removal of the contaminated humidifier from the home environment.

Implications:

  • This case highlights the potential for ultrasonic humidifiers to harbor and disseminate molds like T. viride, leading to HP.
  • It underscores the importance of considering environmental exposures, particularly contaminated water sources, in the differential diagnosis of HP.
  • This is the first reported instance linking T. viride from a humidifier to hypersensitivity pneumonitis, emphasizing the need for vigilance in home environmental assessments.