title: Chacinero's lung - hypersensitivity pneumonitis due to dry sausage dust.
abstract: OBJECTIVE
  Hypersensitivity pneumonitis (HP) comprises a large group of diseases that occur secondary to inhalation of a variety of antigens. This report describes a little-known cause of HP, previously unreported in the English literature.
  
  
  METHODS
  Five patients (three women) with a mean age of 41 years who fulfilled the criteria for HP due to exposure to dry sausage dust were studied. The clinical findings, immunologic testing, results of the specific inhalation challenge, and follow-up are described.
  
  
  RESULTS
  Three patients developed an acute form of disease and two patients a subacute form. A diffuse micronodular centrolobular pattern was seen on high-resolution computer tomography scanning of four patients. A restrictive pattern was identified on pulmonary function testing of four patients and decreased lung diffusion of carbon monoxide (DLCO) among three. In bronchoalveolar lavage specimens from three patients, lymphocytosis was 17%, 40%, and 40%, with a CD4/CD8 ratio of <0.6. Specific immunoglobin G (IgG) antibodies to Penicillium frequentans and Aspergillus fumigatus were positive for three patients. Performed on three patients, the specific inhalation challenge was positive for dry sausage dust extract in two cases and Penicillium frequentans in the third. Resolution of clinical, radiologic, spirometry, and DLCO alterations occurred among the three patients who avoided exposure following the diagnosis.
  
  
  CONCLUSIONS
  A short patient series affected by a little-known cause of occupational HP is described. Penicillium frequentans may be the causative agent in some cases, but other fungi were found that could also be implicated in the etiology of this disease.
authors.affiliation: Servicio de Neumología, Hospital Vall d'Hebron, 08035 Barcelona, Spain.
authors.forename: Ferran
authors.initials: F
authors.lastname: Morell
authors.forename: Maria-Jesus
authors.initials: MJ
authors.lastname: Cruz
authors.forename: Francisco Pedro
authors.initials: FP
authors.lastname: Gómez
authors.forename: Francisco
authors.initials: F
authors.lastname: Rodriguez-Jerez
authors.forename: Antoni
authors.initials: A
authors.lastname: Xaubet
authors.forename: Xavier
authors.initials: X
authors.lastname: Muñoz
mesh_terms: D000328:Adult; D000542:Alveolitis, Extrinsic Allergic / Q000209:etiology* / Q000382:microbiology; D001232:Aspergillus fumigatus / Q000276:immunology / Q000302:isolation & purification; D004391:Dust; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D019570:Inhalation Exposure; D008461:Meat Products / Q000382:microbiology*; D008875:Middle Aged; D009784:Occupational Diseases / Q000209:etiology* / Q000382:microbiology; D010407:Penicillium / Q000276:immunology / Q000302:isolation & purification; D012882:Skin Tests; D013030:Spain
chemical_list: D004391:Dust; D007074:Immunoglobulin G