Allergic alveolitis among agricultural workers in eastern Poland: a study of twenty cases

The aim of this study was to identify the specific agents which caused extrinsic allergic alveolitis (EAA) in the selected group of 20 agricultural workers from eastern Poland. The microbiological analysis of the samples of plant materials or dusts reported by the patients as causing symptoms has been carried out, followed by allergological tests (inhalation challenge, agar-gel precipitation test, inhibition of leukocyte migration, skin test) with extrinsic microbial antigens. It was found that the causative agents of allergic alveolitis in the examined group of patients were mesophilic, non-branching bacteria associated with grain dust, mostly Pantoea agglomerans (synonyms: Erwinia herbicola, Enterobacter agglomerans) and Arthrobacter globiformis (each in eight cases). The remaining agents were Alcaligenes faecalis (in two cases), and Brevibacterium linens and Staphylococcus epidermidis (in one case each). On the basis of the clinical picture, the bronchoalveolar lavage (BAL) and allergological tests, the diagnosis of the chronic form of the disease was stated in 14 patients and an acute form - in 6 patients. EAA patients demonstrated in the BAL fluid a typical lymphocytic alveolitis both in terms of percentage and absolute number of lymphocytes. Also, the numbers of eosinophils and neutrophils were significantly higher in EAA patients.