1/8. hypersensitivity pneumonitis from home mist machine after laryngectomy.hypersensitivity pneumonitis is an unusual complication of using humidification devices. It is characterized by the acute onset of dyspnea, cough, fever, and chills after exposure to an offending antigen. This report describes a 54-year-old female laryngectomee who had repeated hospitalizations for postoperative dyspnea with normal chest roentgenograms and sputum cultures, but findings and history consistent with acute hypersensitivity pneumonitis. This seems to be the first reported case of hypersensitivity pneumonitis in a laryngectomee using a home mist machine. When repeated episodes of dyspnea occur in such patients, hypersensitivity pneumonitis should be considered in the differential diagnosis.- - - - - - - - - - ranking = 1keywords = chill (Clic here for more details about this article) |
2/8. Mould exposure in museum personnel.In the basement archives of a local arts and crafts museum where the books and bookkeeping registers were handled, a woman on the museum staff had had ten attacks of fever, chill, nausea and cough during one year. The symptoms appeared at the end of the working day and disappeared after one to three days at home. No symptoms could be detected during the summer holidays. The books stored in the basement archives had earlier been stored in a small house with a leaky roof, which had led to the growth of mould on the books. When the books were handled at the museum, they were still covered with mould. The exposure measurements showed 10(6) CFU/m3 and a total of 10(8) microorganisms/m3.- - - - - - - - - - ranking = 1keywords = chill (Clic here for more details about this article) |
3/8. hypersensitivity pneumonitis caused by cladosporium in an enclosed hot-tub area.A 48-year-old woman had an 18-month history of malaise and chronic cough with intermittent episodes of fever, chills, and pneumonic infiltrates. Transbronchial biopsy findings were consistent with hypersensitivity pneumonitis. Cultures of fungus from a hot-tub room in her home were positive for cladosporium species. serum precipitins were weakly positive for cladosporium cladosporioides. Removal of the patient from the home environment led to a resolution of symptoms within 1 week. Within 4 hours of re-exposure to the hot-tub room, symptoms and signs and changes in leukocyte count and spirometric values again occurred. Bronchial provocation with a commercial extract of C. cladosporioides led to a similar pattern 5 hours after the initial challenge. This case identifies a previously unreported etiologic agent and environmental site for hypersensitivity pneumonitis.- - - - - - - - - - ranking = 1keywords = chill (Clic here for more details about this article) |
4/8. Combined asthma and alveolitis induced by cobalt in a diamond polisher.A diamond polisher presented with a history of dyspnea, chest tightness, chills and weight loss related to exposure to diamond cobalt disks at work. Pulmonary function showed slightly reduced lung volumes, low normal diffusing capacity and a moderate bronchial hyperresponsiveness to histamine. Chest X-ray and cell count in bronchoalveolar lavage fluid were normal. After 3 months of non-exposure, a bronchial cobalt challenge test caused an immediate decrease in specific airway conductance and in vital capacity (VC) but not in FEV1/VC. After 6 h, chills, fever, tachycardia and crackles appeared along with moderate reductions in lung volumes. After 24 h, the bronchoalveolar lavage fluid showed 43% granulocytes, and there was a marked increase in bronchial hyperresponsiveness to histamine. These changes are interpreted as combined asthma and alveolitis induced by cobalt.- - - - - - - - - - ranking = 2keywords = chill (Clic here for more details about this article) |
5/8. Acute pneumonitis associated with MOPP chemotherapy of Hodgkin's disease.A case of a 69-year-old man admitted with procarbazine pneumonitis and a review of the literature are presented. The patient completed a second course of MOPP chemotherapy for Hodgkin's disease three days before admission. He presented with a recent onset of fever, chills, anorexia, and malaise. Chest radiography indicated diffuse bilateral interstitial pneumonitis, and pulmonary function studies revealed restrictive lung disease. Attempts to identify an infectious etiology, including open lung biopsy, were negative, and empirical antibiotic therapy was ineffective. The diagnosis was drug-induced hypersensitivity reaction, most likely due to procarbazine. Corticosteroid therapy was instituted with gradual improvement. Six other cases of pneumonitis associated with procarbazine therapy are briefly reviewed, and the use of pulmonary function tests to identify the type and degree of injury and monitor therapy is discussed.- - - - - - - - - - ranking = 1keywords = chill (Clic here for more details about this article) |
6/8. hypersensitivity pneumonitis-like reaction and occupational asthma associated with 1,3-bis(isocyanatomethyl) cyclohexane pre-polymer.Twenty-three of 34 workers who had worked in the injection molding operation making polyurethane foam parts at an automobile parts manufacturing plant developed respiratory symptoms and/or systemic symptoms over a 2-month period following the full production use of a new diisocyanate paint that contained 1,3-bis(isocyanatomethyl)cyclohexane pre-polymer (BIC)(CAS #75138-76-0, 38661-72-2). At 3 months, all subjects underwent an interview, physical examination, pre- and post-shift pulmonary function tests, and either methacholine challenge test or bronchodilator challenge at an occupational health clinic. The most frequently cited symptoms were dyspnea (65%), cough (61%), chest tightness (57%), chills (57%), wheezing (30%), and myalgias, arthralgias, and nausea (26%). Thirteen subjects had either a positive methacholine challenge test or a positive response to bronchodilator challenge, making the overall prevalence of airway hyperresponsiveness 38%. The overall prevalence of hypersensitivity pneumonitis-like reactions among line operators in the injection molding process was 27%. This disease outbreak suggests that 1,3-bis(isocyanatomethyl)cyclohexane pre-polymer may cause asthma and hypersensitivity pneumonitis-like reactions. The use of BIC was discontinued 6 months after the first workers developed symptoms.- - - - - - - - - - ranking = 1keywords = chill (Clic here for more details about this article) |
7/8. Allergic alveolitis following exposure to epoxy polyester powder paint containing low amounts (<1%) of acid anhydrides.Only one case report concerning allergic alveolitis caused by polyester powder paint has been published previously. The aim of this study was to determine whether phthalic anhydride (PA) or trimellitic anhydride (TMA) is the alveolitis-causing agent in such paint. A 61 year old woman showed recurrent symptoms of chills, cough, and fever whilst at work. She was working in a plant where epoxy polyester powder paints were used to paint metal. The paint was found to contain low (<1%) amounts of TMA and PA. The patient showed shadowing on chest radiographs. In bronchoalveolar lavage, lymphocytosis (67%) and a low T-helper/T-suppressor ratio (0.2) were found. transfer factor was within normal limits, but a slight reduction was verified after re-exposure to the paint. The symptoms, exposure, reduction in transfer factor, findings on chest radiographs and bronchoalveolar lavage were consistent with allergic alveolitis. In conclusion, the polyester powder paint used in the plant caused allergic alve olitis in this patient. Of the constituents in the paint, trimellitic anhydride and phthalic anhydride were the possible causative agents.- - - - - - - - - - ranking = 1keywords = chill (Clic here for more details about this article) |
8/8. Sauna-takers disease. hypersensitivity pneumonitis due to contaminated water in a home sauna.Daily saunas taken by a young man were followed by fever, chills, malaise, dyspnea, cough, and myalgia from six to eight hours later. Symptoms, which were related to pouring water from a sauna bucket over the heating element, progressed to chronic dyspnea and fatigue. Serial serum samples showed precipitin reactions to bucket water and extracts of bucket mold. IgG antibody activity, demonstrated by radioimmunoassay, suggested that Pullularia was a major antigen.- - - - - - - - - - ranking = 1keywords = chill (Clic here for more details about this article) |