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[Acute dyspnea, cough, headache].

M Misteli1, A Ragaz

  • 1Medizinische Klinik, Kantonsspital Aarau.

Schweizerische Rundschau Fur Medizin Praxis = Revue Suisse De Medecine Praxis
|March 5, 1991
PubMed
Summary
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A worker developed acute respiratory distress after working in a silo, diagnosed as silo-filler's disease. Prompt steroid treatment led to rapid recovery and normalized lung function.

Area of Science:

  • Environmental Medicine
  • Occupational Health
  • Pulmonology

Background:

  • Silo-filler's disease is a potentially fatal lung condition caused by exposure to toxic gases released during the ensilage process.
  • Nitrogen oxides (NOx) are the primary culprits, generated from the fermentation of fresh plant material, particularly corn.
  • Enclosed, poorly ventilated spaces like silos exacerbate the risk of high gas concentrations.

Observation:

  • A 27-year-old male experienced acute cough, dyspnea, and weakness six hours after working in an unventilated silo.
  • Clinical presentation included severe partial respiratory insufficiency requiring mechanical ventilation and bilateral alveolo-interstitial opacity on chest X-ray.
  • Exposure history revealed the adjacent silo was recently filled with green corn, with a shared wall and noted yellow discoloration in the work silo.

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Findings:

  • The patient was diagnosed with silo-filler's disease based on clinical symptoms, exposure, and radiological findings.
  • Rapid improvement in respiratory function and resolution of lung opacities were observed following high-dose corticosteroid therapy.
  • Complete lung function normalization occurred within nine days, with continued steroid treatment for six weeks.

Implications:

  • This case highlights the critical importance of recognizing silo-filler's disease in agricultural workers with acute respiratory symptoms.
  • Early diagnosis and aggressive treatment, including prompt steroid administration, are crucial for favorable outcomes and preventing long-term lung damage.
  • Emphasizes the need for enhanced safety protocols and ventilation awareness in agricultural settings involving silo operations.