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Hypersensitivity pneumonitis due to mushroom (Pholiota nameko) spores
1College of Medical Care and Technology, Gunma University School of Medicine, Japan.
Abstract:
Hypersensitivity pneumonitis due to the inhalation of spores from the edible mushroom Pholiota nameko was demonstrated. A 52-year-old mushroom worker noticed cough, exertional dyspnea, and high fever several hours after work in the mushroom-cultivating room. His examination revealed bilateral basilar crepitations, fine granular shadows in both lung fields of chest x-ray film, and slight decrease in diffusion capacity. Precipitin and macrophage migration inhibition factor were found against the mushroom spore extract and not other contaminants and molds. Histologic finding by transbronchial lung biopsy showed granulomatous alveolitis. Manifest increase of lymphocytes was found in his bronchoalveolar lavage fluid. Provocative inhalation test with the extract revealed similar symptoms and signs in his workplace eight hours after inhalation. It seems to be the first case of hypersensitivity pneumonitis to the Pholiota nameko mushroom spores.
Insights
This study identifies hypersensitivity pneumonitis caused by edible mushroom spores. A mushroom worker developed lung inflammation after exposure to Pholiota nameko spores.
Area of Science:
- Pulmonary Medicine
- Immunology
- Occupational Health
Background:
- Hypersensitivity pneumonitis (HP) is an immune-mediated lung disease.
- Mushroom cultivation involves exposure to fungal spores, a potential allergen.
Observation:
- A mushroom worker presented with acute respiratory symptoms including cough, dyspnea, and fever after working in a Pholiota nameko cultivation room.
- Clinical examination revealed bilateral lung crepitations and characteristic radiographic findings.
Findings:
- Specific antibodies (precipitin) and cellular immune response (macrophage migration inhibition factor) were detected against Pholiota nameko spore extract.
- Transbronchial lung biopsy showed granulomatous alveolitis, and bronchoalveolar lavage revealed increased lymphocytes.
- A provocative inhalation test confirmed the causal link between Pholiota nameko spore exposure and symptom development.
Implications:
- This case highlights Pholiota nameko spores as a novel cause of hypersensitivity pneumonitis.
- Occupational health strategies should consider specific fungal allergens in mushroom cultivation.
- Further research into fungal spore-induced lung diseases is warranted.