title: Extrinsic allergic alveolitis caused by misting fountains.
abstract: Recently, an increasing number of patients were presented to our clinics with febrile and respiratory symptoms associated with exposure to a new type of domestic ultrasonic humidifier. We report on 11 patients who developed recurrent episodes of fever, cough and dyspnea after repeated exposure to ultrasonic misting fountains at home. A diagnosis of extrinsic allergic alveolitis (EAA) or toxic alveolitis was made on the basis of the history and the clinical, radiological, laboratory and immunological findings. Eight patients were subjected to inhalative challenge tests with their own ultrasonic misting fountains, and all of them exhibited positive reactions. Nine patients were diagnosed with an EAA (humidifier lung) and two patients with a toxic alveolitis (humidifier fever). This study demonstrates the potential for ultrasonic misting fountains to cause illness in the home. In view of the increasing popularity of these devices, humidifier lung and humidifier fever should be considered in the differential diagnosis of patients with unexplained pulmonary or flu-like illnesses with fever.
authors.affiliation: Zusamklinik der LVA Schwaben, Pneumology, Allergy and Sleep Medicine, Paracelsusstr. 3, 86441 Zusmarshausen, Germany. dirk.koschel@lva-schwaben.de
authors.forename: Dirk
authors.initials: D
authors.lastname: Koschel
authors.forename: Wolfram
authors.initials: W
authors.lastname: Stark
authors.forename: Fritz
authors.initials: F
authors.lastname: Karmann
authors.forename: Jochen
authors.initials: J
authors.lastname: Sennekamp
authors.forename: Dietrich
authors.initials: D
authors.lastname: Müller-Wening
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000389:Air Conditioning / Q000009:adverse effects*; D000542:Alveolitis, Extrinsic Allergic / Q000209:etiology* / Q000276:immunology / Q000382:microbiology; D000907:Antibodies, Bacterial / Q000097:blood; D004866:Equipment Contamination; D005260:Female; D006801:Humans; D006813:Humidity; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D014465:Ultrasonics; D014871:Water Microbiology
chemical_list: D000907:Antibodies, Bacterial; D007074:Immunoglobulin G