1/6. Bird fanciers' lung: a case report.The clinical course of a case of bird fanciers' lung is described along with the considerations that are important in the management of this form of hypersensitivity pneumonitis. Diagnostic parameters, therapeutic considerations, and environmental issues are discussed in the context of the current literature.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
2/6. Cockatiel-induced hypersensitivity pneumonitis.Diagnosing an environmental or occupationally related pulmonary disorder often involves a process of elimination. Unlike commonly diagnosed conditions in other specialties, a cause-and-effect relationship may be implied, yet other factors such as temporality and biologic plausibility are lacking. Our patient was referred with a suspected work-related pulmonary disorder. For several years, she had suffered with dyspnea on exertion and repeated flulike illnesses. She worked at an automobile repair garage that performed a large number of emission tests, and there was concern that her workplace exposures were the cause of her symptoms. After a careful review of her history, physical examination, and laboratory testing, we came to the conclusion that she had hypersensitivity pneumonitis related to pet cockatiels in her home. Clinical points of emphasis include the importance of a complete environmental history and careful auscultation of the chest when performing the physical examination. In addition, we encountered an interesting physical diagnostic clue, a respiratory sound that assisted with the eventual diagnosis.- - - - - - - - - - ranking = 2keywords = environment (Clic here for more details about this article) |
3/6. Rosella parrot exposure as a cause of bird fancier's lung.A case of a 30-year-old man who presented with a 2-month history of progressively worsening dyspnoea, cough, and reduced exercise tolerance is discussed. A chest x-ray and computerized tomography of the chest suggested interstitial lung disease, which was confirmed on histology of an open lung biopsy. Careful questioning revealed that the patient had sustained close exposure to a rosella parrot acquired as a pet 9 months prior to presentation, which led to the diagnosis of bird fancier's lung. The case, investigations, and outcome are presented. This is followed by a discussion on extrinsic allergic alveolitis with particular emphasis on the importance of a complete social and environmental history in patients presenting with similar respiratory symptoms.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
4/6. Environmental challenge.A variety of organic dusts and chemicals encountered in our environment are capable of provoking a response in the lung. Frequently, they produce transient or reversible physiologic changes that may obscure the diagnosis. The patient may fail to recognize a causal relationship with a specific exposure with late-onset reactions and the development of symptoms remote from the exposure. A thorough evaluation of the individual's total environment and symptoms, with particular reference to their time course, is essential in making the diagnosis. Removal of the worker from a suspected environment, with serial clinical and physiologic monitoring to demonstrate improvement, or return to the workplace with similar studies, can be helpful in establishing a causal relationship. When a specific agent can be identified, a controlled inhalation challenge in the laboratory is the procedure of choice. Once a causal relationship has been established, the individual should be removed from exposure or the implicated agent eliminated.- - - - - - - - - - ranking = 3keywords = environment (Clic here for more details about this article) |
5/6. 'Atypical pneumonia' due to parakeet sensitivity: bird fancier's lung in a 10-year-old girl.p6trinsic allergic alveolitis is rare in childhood, with most of the cases reported due to exposure to avian precipitins (Stiem et al. 1966; Dinda et al. 1969; Chandra & Everly Jones 1972; El-Hefny et al. 1980). We report a 10-year-old girl with bird fancier's lung, and suggest that environmental antigens should be sought in children presenting with non-resolving chest disease.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
6/6. Pigeon breeder's disease in children. A family study.The findings in a family of seven with pigeon breeder's disease are reported, and the wide range of clinical and laboratory involvement is documented. An inhalational challenge and lung biopsy were performed on the 15-year-old patient who was the index case, and the diagnostic results are discussed. We emphasize the importance of thoroughly evaluating the members of the family and the environment when a patient suspected of hypersensitivity pneumonitis is encountered. All treated members responded well to therapy with steroids and ceasing exposure to antigenic material from pigeons. serum precipitin tests to pigeon-derived antigens that were initially strongly positive in all seven family members became negative by 15 months following treatment.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |