Humidifier lung: possible contribution of endotoxin-induced lung injury.
A 56-year-old man was admitted with cough, fever, myalgia, and arthralgia. Chest computed tomography demonstrated bilateral diffuse ground-glass opacities predominantly in the upper lungs. Subpleural non-segmental consolidation was observed in the late phase. Hypersensitivity pneumonitis was suspected, and an environmental provocation test with the incidental use of a home ultrasonic humidifier was positive. Unlike typical hypersensitivity pneumonitis, serum KL-6 levels were normal. Although several microorganisms were isolated from the humidifier water, there was no evidence for immune sensitization. We detected high amounts of endotoxin in the humidifier water, which may have contributed to the lung injury of this patient.
Ohnishi
Hiroshi
H
Second Department of Internal Medicine, Ehime University School of Medicine, Onsen-gun, Ehime.
Yokoyama
Akihito
A
Hamada
Hironobu
H
Manabe
Seiko
S
Ito
Ryoji
R
Watanabe
Akira
A
Katayama
Hitoshi
H
Yasuhara
Yoshifumi
Y
Ikezoe
Junpei
J
Higaki
Jitsuo
J
D000542:Alveolitis, Extrinsic Allergic / Q000097:blood / Q000209:etiology*; D000941:Antigens / Q000097:blood; D000951:Antigens, Neoplasm; D015415:Biomarkers / Q000097:blood; D018893:Bronchoalveolar Lavage; D016516:CD4-CD8 Ratio; D004731:Endotoxins / Q000009:adverse effects*; D006023:Glycoproteins / Q000097:blood; D006801:Humans; D006813:Humidity / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D018396:Mucin-1; D009077:Mucins; D014057:Tomography, X-Ray Computed
D000941:Antigens; D000951:Antigens, Neoplasm; D015415:Biomarkers; D004731:Endotoxins; D006023:Glycoproteins; C060192:MUC1 protein, human; D018396:Mucin-1; D009077:Mucins