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Hypersensitivity pneumonitis due to molds in a saxophone player

Flora Metzger1, Amaryllis Haccuria, Gabriel Reboux

  • 1Department of Respiratory Disease, Jean Minjoz University Hospital, Besançon, France. fmetzger@chu-besancon.fr

Chest
|September 9, 2010
PubMed

Insights

Hypersensitivity pneumonitis can develop in saxophone players due to mold exposure. Identifying molds like Ulocladium botrytis in instruments is crucial for diagnosis and treatment.

Area of Science:

  • Pulmonology
  • Environmental Medicine
  • Microbiology

Background:

  • Nonspecific interstitial pneumonia (NSIP) can have various causes.
  • Hypersensitivity pneumonitis (HP) is an immune-mediated lung disease often triggered by inhaled antigens.
  • Diagnosing HP requires integrating clinical, radiological, and pathological findings.

Observation:

  • A patient presented with interstitial pneumonia, exhibiting mosaic ground-glass opacities on CT and lymphocytic alveolitis on bronchoalveolar lavage (BAL).
  • The patient, a saxophone player, had no other identifiable mold exposures.
  • Ulocladium botrytis and Phoma sp. were identified in the patient's saxophone, with corresponding precipitating antibodies in serum.

Findings:

  • The clinical, radiological, and BAL findings suggested hypersensitivity pneumonitis.
  • The saxophone was identified as the likely source of mold exposure leading to HP.
  • Saxophones are frequently colonized with potentially pathogenic molds.

Implications:

  • This case highlights a novel risk factor for hypersensitivity pneumonitis: wind instrument playing, specifically the saxophone.
  • Respiratory physicians should consider HP in musicians with unexplained interstitial lung disease.
  • Further research into mold contamination of musical instruments and associated health risks is warranted.

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