title: Acute toxic pneumonitis complicating chronic obstructive pulmonary disease (COPD) in a farmer.
abstract: 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.
authors.affiliation: 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.
authors.forename: Sigurdur T
authors.initials: ST
authors.lastname: Sigurdarson
authors.forename: Kelley J
authors.initials: KJ
authors.lastname: Donham
authors.forename: Joel N
authors.initials: JN
authors.lastname: Kline
mesh_terms: 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*
chemical_list: D004391:Dust