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Hypersensitivity Pneumonitis Due to Molds in a Saxophone Player

Flora Metzger, MD; Amaryllis Haccuria, MD; Gabriel Reboux, PhD; Nicole Nolard, MD; Jean-Charles Dalphin, MD, PhD; Paul De Vuyst, MD, PhD
Author and Funding Information

From the Department of Respiratory Disease (Drs Metzger and Dalphin) and the Department of Mycology (Dr Reboux), Jean Minjoz University Hospital, Besançon, France; Hôpital Erasme (Drs Haccuria and De Vuyst), Université libre de Bruxelles, Brussels, Belgium; and Scientific Institute of Public Health (Dr Nolard), Brussels, Belgium.

Correspondence to: Flora Metzger, MD, Department of Respiratory Disease, Jean Minjoz University Hospital, 3 bvd Alexander Fleming, 25030, Besançon, France; e-mail: fmetzger@chu-besancon.fr


For editorial comment see page 467

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2010 American College of Chest Physicians


Chest. 2010;138(3):724-726. doi:10.1378/chest.09-2991
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This 48-year-old patient was evaluated for an interstitial pneumonia. An open-lung biopsy showed a pattern of nonspecific interstitial pneumonia. The CT scan appearance, showing mosaic ground-glass opacities in the ventilated parts of the lung, the centrolobular predominance of inflammation on the lung sections, and the presence of a lymphocytic alveolitis at BAL suggested a hypersensitivity pneumonitis. The patient was a white-collar worker and had no contact with pets, birds, drugs, or molds at home. He used to play the saxophone as a hobby. Two molds, Ulocladium botrytis and Phoma sp, were detected in the saxophone. Precipitating antibodies to these molds were present in his serum. An additional study confirmed the frequent colonization of saxophones with potentially pathogenic molds, such as Fusarium sp, Penicillium sp, and Cladosporium sp. Respiratory physicians should be aware of the risk of hypersensitivity pneumonitis in saxophone or perhaps other wind instrument players.

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