title: Hypersensitivity pneumonitis due to molds in a saxophone player.
abstract: This 48-year-old patient was evaluated for an interstitial pneumonia. An open-lung biopsy showed a pattern of nonspecific interstitial pneumonia. The CT scan appearance, showing mosaic ground-glass opacities in the ventilated parts of the lung, the centrolobular predominance of inflammation on the lung sections, and the presence of a lymphocytic alveolitis at BAL suggested a hypersensitivity pneumonitis. The patient was a white-collar worker and had no contact with pets, birds, drugs, or molds at home. He used to play the saxophone as a hobby. Two molds, Ulocladium botrytis and Phoma sp, were detected in the saxophone. Precipitating antibodies to these molds were present in his serum. An additional study confirmed the frequent colonization of saxophones with potentially pathogenic molds, such as Fusarium sp, Penicillium sp, and Cladosporium sp. Respiratory physicians should be aware of the risk of hypersensitivity pneumonitis in saxophone or perhaps other wind instrument players.
authors.affiliation: Department of Respiratory Disease, Jean Minjoz University Hospital, Besançon, France. fmetzger@chu-besancon.fr
authors.forename: Flora
authors.initials: F
authors.lastname: Metzger
authors.forename: Amaryllis
authors.initials: A
authors.lastname: Haccuria
authors.forename: Gabriel
authors.initials: G
authors.lastname: Reboux
authors.forename: Nicole
authors.initials: N
authors.lastname: Nolard
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Dalphin
authors.forename: Paul
authors.initials: P
authors.lastname: De Vuyst
mesh_terms: D000542:Alveolitis, Extrinsic Allergic / Q000175:diagnosis* / Q000382:microbiology* / Q000628:therapy; D020171:Botrytis; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009146:Music; D009784:Occupational Diseases / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy