title: [Interstitial lung disease due to domestic moulds].
abstract: Identifying the role of fungi present in the domestic environment in the development of interstitial pneumonia can be a difficult clinical problem. We report a case of interstitial lung disease case occurring in a 53-year-old patient. He presented with profound hypoxemia (PaO(2) 54mmHg). Chest CT showed diffuse ground glass opacities. Initial blood tests for allergy and autoimmune disease were negative. Faced with a worsening of his clinical status after returning home he was hospitalized several times. At fibreoptic bronchoscopy, multiple white deposits were observed. Bronchoalveolar lavage with differential cell count was performed, revealing a 23% lymphocytosis. Serology for specific household molds showed moderate reaction to various molds found in homes, especially Stachybotrys chartarum. Pulmonary function tests revealed a moderate restrictive pattern with impaired diffusion of carbon monoxide and a bronchiolocentric interstitial pneumonia was found at lung biopsy. After a permanent move to a new residence, clinical parameters, radiological, biological and functional normalized. The final diagnosis was interstitial lung disease related to mycotoxins of S. Chartarum. The diagnosis of hypersensitivity pneumonitis to domestic mold or interstitial lung disease secondary to mycotoxins should be considered in patients presenting with interstitial pneumonia and requires specific investigations to ensure that an environmental cause with an allergic or toxic role is not missed.
authors.affiliation: Service de pneumologie et immunoallergologie, centre de compétence des maladies pulmonaires rares, CHRU hôpital Calmette, boulevard du Pr-J.-Leclercq, 59037 Lille cedex, France.
authors.forename: A-L
authors.initials: AL
authors.lastname: Blanc
authors.forename: L
authors.initials: L
authors.lastname: Delhaes
authors.forename: M-C
authors.initials: MC
authors.lastname: Copin
authors.forename: B
authors.initials: B
authors.lastname: Stach
authors.forename: J-B
authors.initials: JB
authors.lastname: Faivre
authors.forename: B
authors.initials: B
authors.lastname: Wallaert
mesh_terms: D000391:Air Microbiology; D016902:Air Pollution, Indoor / Q000009:adverse effects*; D000908:Antibodies, Fungal / Q000097:blood; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology; D001999:Bronchoscopy; D004391:Dust; D004781:Environmental Exposure; D005602:France; D005658:Fungi / Q000302:isolation & purification; D006798:Housing; D006801:Humans; D000860:Hypoxia / Q000209:etiology; D017563:Lung Diseases, Interstitial / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009183:Mycotoxins / Q000009:adverse effects*; D011653:Pulmonary Diffusing Capacity; D011859:Radiography; D013191:Stachybotrys / Q000276:immunology / Q000302:isolation & purification / Q000502:physiology; D014871:Water Microbiology
chemical_list: D000908:Antibodies, Fungal; D004391:Dust; D009183:Mycotoxins