1/2. A family with extrinsic allergic alveolitis caused by wild city pigeons: A case report.We describe a family in which the mother died of unresolved lung disease and whose 5 children, some of whom had previous signs of asthma, were subsequently affected by extrinsic allergic alveolitis caused by contact with wild city pigeon antigens. The children received systemic corticosteroids for 1 month and inhaled steroids for 24 months, while antigen exposure was reduced as much as feasible. This was followed by a quick clinical recovery and a slow normalization of chest radiographs and pulmonary function indices, especially of diffusion capacity, during a follow-up of 24 months. Because pigeon-breeder's lung caused by free-roaming city pigeons has not been previously described, it remains unclear whether this family developed the disease because of high antigen exposure or because of increased susceptibility. None of the supposedly high-risk human leukocyte antigen types were found in the children. Whether human leukocyte antigen B7 in 1 child played a role in the course of the illness remains speculative. It is unknown to what extent pigeon-breeder's lung caused by nondomestic birds remains undetected and misdiagnosed as difficult or steroid-resistant asthma. The question remains whether free-roaming city pigeons are indeed a public health risk. We suggest that atypical outdoor antigens be considered in all patients with nonresolving chest disease or therapy-resistant asthma.- - - - - - - - - - ranking = 1keywords = wild (Clic here for more details about this article) |
2/2. hypersensitivity pneumonitis in a raptor handler and a wild bird fancier.BACKGROUND: hypersensitivity pneumonitis has been associated with a variety of antigens in various settings. We have recently encountered one case of hypersensitivity pneumonitis from owl droppings and another case from a wild Moluccan cockatoo. OBJECTIVE: It is important to alert physicians to the possibility of hypersensitivity pneumonitis when dealing with wildlife workers and wild bird fanciers. METHOD: A report of two cases with progress and response to therapy. RESULTS: Clinical and serologic information are of value in the diagnosis of hypersensitivity pneumonitis due to birds and avoidance is the optimal approach. CONCLUSION: There are many raptor handlers and wild bird fanciers across the united states and the world. Given the incidence of hypersensitivity pneumonitis in pigeon breeders, this may herald a new variant of allergic disease among wildlife workers and wild bird fanciers.- - - - - - - - - - ranking = 2keywords = wild (Clic here for more details about this article) |