title: Hypersensitivity pneumonitis caused by Cladosporium in an enclosed hot-tub area.
abstract: A 48-year-old woman had an 18-month history of malaise and chronic cough with intermittent episodes of fever, chills, and pneumonic infiltrates. Transbronchial biopsy findings were consistent with hypersensitivity pneumonitis. Cultures of fungus from a hot-tub room in her home were positive for Cladosporium species. Serum precipitins were weakly positive for Cladosporium cladosporioides. Removal of the patient from the home environment led to a resolution of symptoms within 1 week. Within 4 hours of re-exposure to the hot-tub room, symptoms and signs and changes in leukocyte count and spirometric values again occurred. Bronchial provocation with a commercial extract of C. cladosporioides led to a similar pattern 5 hours after the initial challenge. This case identifies a previously unreported etiologic agent and environmental site for hypersensitivity pneumonitis.
mesh_terms: D000542:Alveolitis, Extrinsic Allergic / Q000209:etiology*; D001494:Baths; D001985:Bronchial Provocation Tests; D002963:Cladosporium / Q000276:immunology*; D004391:Dust; D005260:Female; D006801:Humans; D008875:Middle Aged; D003904:Mitosporic Fungi / Q000276:immunology*; D011234:Precipitins / Q000032:analysis; D012882:Skin Tests; D013997:Time Factors; D014871:Water Microbiology
chemical_list: D004391:Dust; D011234:Precipitins