title: Hypersensitivity pneumonitis in a high school teacher.
abstract: Hypersensitivity pneumonitis (HP) is an inflammatory lung disease mediated by an immunological response to an inhaled antigen. Outbreaks of HP have been reported in industrial settings where manufacturing workers are exposed to water-based metalworking fluids (MWFs). Water-based MWFs promote growth of microorganisms and can be easily aerosolized and are thus potential aetiological agents of HP. We present a case of HP caused by exposure to water-based MWF in a vocational high school teacher. Culture of MWF used at his school grew Pseudomonas pseudoalcaligenes. This is the first known report of MWF-induced HP outside an industrial setting. The growth of Pseudomonas spp in this case recalls the earliest reports of the microbiology of MWF-induced HP and suggests that routine bacterial culture may be useful in the diagnosis of HP in workplaces without standard cleaning and biocide regulations.
authors.affiliation: Brigham and Women's Hospital, Division of Pulmonary and Critical Care Medicine, PBB-CA-3, 75 Francis Street, Boston, MA 02115, USA. amoniodis@partners.org.
authors.forename: A
authors.initials: A
authors.lastname: Moniodis
authors.affiliation: Brigham and Women's Hospital, Division of Pulmonary and Critical Care Medicine, PBB-CA-3, 75 Francis Street, Boston, MA 02115, USA.
authors.forename: T
authors.initials: T
authors.lastname: Hamilton
authors.affiliation: Brigham and Women's Hospital, Division of Pulmonary and Critical Care Medicine, PBB-CA-3, 75 Francis Street, Boston, MA 02115, USA.
authors.forename: E
authors.initials: E
authors.lastname: Racila
authors.affiliation: Brigham and Women's Hospital, Division of Pulmonary and Critical Care Medicine, PBB-CA-3, 75 Francis Street, Boston, MA 02115, USA.
authors.forename: B
authors.initials: B
authors.lastname: Cockrill
authors.affiliation: Brigham and Women's Hospital, Division of Pulmonary and Critical Care Medicine, PBB-CA-3, 75 Francis Street, Boston, MA 02115, USA.
authors.forename: R
authors.initials: R
authors.lastname: McCunney
mesh_terms: D000542:Alveolitis, Extrinsic Allergic / Q000209:etiology* / Q000382:microbiology; D004203:Disinfection; D006801:Humans; D008297:Male; D008669:Metallurgy; D008875:Middle Aged; D009784:Occupational Diseases / Q000209:etiology* / Q000382:microbiology; D016273:Occupational Exposure / Q000009:adverse effects*; D044205:Pseudomonas pseudoalcaligenes; D000070777:School Teachers; D014867:Water; D017132:Workplace
chemical_list: D014867:Water
keywords: Hypersensitivity pneumonitis; lung disease; occupational hygiene.