Acute toxic pneumonitis complicating chronic obstructive pulmonary disease (COPD) in a farmer.
BACKGROUND
Toxic pneumonitis or Organic Dust Toxic Syndrome (ODTS) is a common, usually self-limiting condition among agricultural workers, occurring after high level exposure to agricultural dust.


METHODS
We describe the case of a 68-year-old smoker and farmer who became ill with dyspnea, flu-like symptoms, and hypoxia after cleaning out a grain bin.


RESULTS
Chest radiograph was normal. He was treated with steroids, antibiotics, and oxygen supplementation and recovered over 3 months, but continues with lingering exercise intolerance after 2 years.


CONCLUSIONS
Although toxic pneumonitis usually follows a relatively benign course with spontaneous recovery and no permanent sequale it can lead to the exacerbation of underlying lung conditions, resulting in incomplete or delayed recovery. Prevention is aimed at limiting exposure by avoidance, by increasing ventilation in closed spaces and by appropriate use of personal protective equipment.
Sigurdarson
Sigurdur T
ST
Division of Pulmonary, Critical Care, and Occupational Medicine, Department of Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa 52242, USA.
Donham
Kelley J
KJ
Kline
Joel N
JN
D000208:Acute Disease; D000368:Aged; D000382:Agricultural Workers' Diseases / Q000209:etiology; D004391:Dust; D006801:Humans; D008297:Male; D016273:Occupational Exposure / Q000009:adverse effects*; D011014:Pneumonia / Q000209:etiology*; D029424:Pulmonary Disease, Chronic Obstructive / Q000209:etiology*
D004391:Dust