Barbara Mackiewicz1, Jacek Dutkiewicz2, Jan Siwiec1, Tomasz Kucharczyk1, Elżbieta Siek3, Angelina Wójcik-Fatla2, Grażyna Cholewa2, Alicja Cholewa2, Mariola Paściak4, Krzysztof Pawlik5, Bogumiła Szponar4, Janusz Milanowski1. 1. Department of Pneumonology, Oncology and Allergology, Medical University, Lublin, Poland. 2. Department of Biological Health Hazards and Parasitology, Institute of Rural Health, Lublin, Poland. 3. Department of Medical Radiology, Medical University, Lublin, Poland. 4. Department of Immunology of Infectious Diseases, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wrocław, Poland. 5. Department of Microbiology, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wrocław, Poland.
Abstract
CASE DESCRIPTION: Five workers (2 males and 3 females) employed in a furniture factory located in eastern Poland developed hypersensitivity pneumonitis (HP) after the pine wood used for furniture production was replaced by birch wood. All of them reported onset of respiratory and general symptoms (cough, shortness of breath, general malaise) after inhalation exposure to birch dust, showed crackles at auscultation, ground-glass attenuations in HRCT examination, and lymphocytosis in the BAL examination. The diagnosis of acute HP was set in 4 persons and the diagnosis of subacute HP in one. IDENTIFICATION OF SPECIFIC ALLERGEN: Samples of birch wood associated with evoking disease symptoms were subjected to microbiological analysis with the conventional and molecular methods. Two bacterial isolates were found to occur in large quantities (of the order 10<sup>8</sup> CFU/g) in examined samples: Gram-negative bacterium of the species <i>Pantoea agglomerans</i> and a non-filamentous Gram-positive actinobacterium of the species <i>Microbacterium barkeri</i>. In the test for inhibition of leukocyte migration, 4 out of 5 examined patients showed a positive reaction in the presence of <i>P. agglomerans</i> and 2 in the presence of <i>M. barkeri</i>. Only one person showed the presence of precipitins to <i>P. agglomerans</i> and none to <i>M. barkeri</i>. In the inhalation challenge, which is the most relevant allergological test in the HP diagnostics, all patients reacted positively to <i>P. agglomerans</i> and only one to <i>M. barkeri</i>. The results indicate that <i>P. agglomerans</i> developing in birch wood was the main agent causing HP in the workers exposed to the inhalation of dust from this wood, while the etiologic role of <i>M. barkeri</i> is probably secondary. CONCLUSION: The results demonstrate that apart from fungi and filamentous actinobacteria, regarded until recently as causative agents of HP in woodworkers, Gram-negative bacteria and non-filamentous actinobacteria may also elicit disease symptoms in the workers processing wood infected with large amounts of these microorganisms. The results obtained also seem to indicate that cellular-mediated reactions are more significant for causing disease symptoms compared to those that are precipitin-mediated.
CASE DESCRIPTION: Five workers (2 males and 3 females) employed in a furniture factory located in eastern Poland developed hypersensitivitypneumonitis (HP) after the pine wood used for furniture production was replaced by birch wood. All of them reported onset of respiratory and general symptoms (cough, shortness of breath, general malaise) after inhalation exposure to birch dust, showed crackles at auscultation, ground-glass attenuations in HRCT examination, and lymphocytosis in the BAL examination. The diagnosis of acute HP was set in 4 persons and the diagnosis of subacute HP in one. IDENTIFICATION OF SPECIFIC ALLERGEN: Samples of birch wood associated with evoking disease symptoms were subjected to microbiological analysis with the conventional and molecular methods. Two bacterial isolates were found to occur in large quantities (of the order 10<sup>8</sup> CFU/g) in examined samples: Gram-negative bacterium of the species <i>Pantoea agglomerans</i> and a non-filamentous Gram-positive actinobacterium of the species <i>Microbacterium barkeri</i>. In the test for inhibition of leukocyte migration, 4 out of 5 examined patients showed a positive reaction in the presence of <i>P. agglomerans</i> and 2 in the presence of <i>M. barkeri</i>. Only one person showed the presence of precipitins to <i>P. agglomerans</i> and none to <i>M. barkeri</i>. In the inhalation challenge, which is the most relevant allergological test in the HP diagnostics, all patients reacted positively to <i>P. agglomerans</i> and only one to <i>M. barkeri</i>. The results indicate that <i>P. agglomerans</i> developing in birch wood was the main agent causing HP in the workers exposed to the inhalation of dust from this wood, while the etiologic role of <i>M. barkeri</i> is probably secondary. CONCLUSION: The results demonstrate that apart from fungi and filamentous actinobacteria, regarded until recently as causative agents of HP in woodworkers, Gram-negative bacteria and non-filamentous actinobacteria may also elicit disease symptoms in the workers processing wood infected with large amounts of these microorganisms. The results obtained also seem to indicate that cellular-mediated reactions are more significant for causing disease symptoms compared to those that are precipitin-mediated.
Authors: Robin B Guevarra; Stefan Magez; Eveline Peeters; Mi Sook Chung; Kyung Hyun Kim; Magdalena Radwanska Journal: PLoS One Date: 2021-01-06 Impact factor: 3.240
Authors: Angelina Wójcik-Fatla; Barbara Mackiewicz; Anna Sawczyn-Domańska; Jacek Sroka; Jan Siwiec; Mariola Paściak; Bogumiła Szponar; Krzysztof Pawlik; Jacek Dutkiewicz Journal: Int Arch Occup Environ Health Date: 2022-01-11 Impact factor: 2.851
Authors: Marcos A Sanchez-Gonzalez; Dave Moskowitz; Priya D Issuree; George Yatzkan; Syed A A Rizvi; Kenneth Day Journal: Infect Chemother Date: 2020-07-15