Aerobiological analysis in a salami factory: a possible case of extrinsic allergic alveolitis byPenicillium camembertii

Abstract

A 39-year-old man was hospitalized with a history of fatigue, dyspnoea and low grade fever which seemed to be related to his working environment. The patient was employed in a salami factory, working near the area where the salami are seasoned with fungal inocula. Chest X-ray showed diffuse initial changes of reticulonodular pattern that disappeared after a brief course of steroids therapy. Precipitating antibodies to Penicillium notatum and Aspergillus fumigatus were found both in plasma and bronchoalveolar lavage fluid. This, together with the finding of a lymphocytic alveolitis with CD4+ depletion and CD8+ increase, suggested the possibility of extrinsic allergic alveolitis of fungal aetiology. Qualitative and quantitative monitoring with an impinger of both the working and outside environment for aerial fungal concentration demonstrated a very high level of contamination (up to 1.14x10(9) fungal propagules m-3 of air) and an inside/outside ratio from 21 to about 2000. Penicillium camembertii was the most common species found in all the indoor sites (60-100% of the fungal load). The patient's BALF and serum both displayed precipitating antibodies to P. camembertii from the powder used for the inoculum and the air samples. These results together with the patient's working history gave some evidence of relationship between the indoor P. camembertii concentration and the patient's symptoms.

Enfermedades del intersticio pulmonar de causa laboral. Parte II

“…por contaminación de fiambre con Penicillium Camemberti en una fábrica de embutidos. [96][97][98][99][100][101][102][103][104][105][106][107][108] Para finalizar, adjuntamos una tabla muy concisa de algunas de las enfermedades profesionales pulmonares que pueden provocar la aparición de NHS y sus causas habituales (Tabla):…”