Lycoperdonosis


Lycoperdonosis is a respiratory disease caused by the inhalation of large amounts of spores from mature puffballs It is classified as a hypersensitivity pneumonitis also called extrinsic allergic alveolitis—an inflammation of the alveoli within the lung caused by hypersensitivity to inhaled natural dusts1 It is one of several types of hypersensitivity pneumonitis caused by different agents that have similar clinical features2 Typical progression of the disease includes symptoms of a cold hours after spore inhalation, followed by nausea, rapid pulse, crepitant rales a sound like that made by rubbing hairs between the fingers, heard at the end of inhalation, and dyspnea Chest radiographs reveal the presence of nodules in the lungs3 The early symptoms presented in combination with pulmonary abnormalities apparent on chest radiographs may lead to misdiagnosis of the disease as tuberculosis, histiocytosis, or pneumonia caused by Pneumocystis carinii Lycoperdonosis is generally treated with corticosteroids, which decrease the inflammatory response; these are sometimes given in conjunction with antimicrobials45

Puffball spores seen with scanning electron microscopy; 5000x magnification

The disease was first described in the medical literature in 1967 by RD Strand and colleagues in the New England Journal of Medicine6 In 1976, a 4-year-old was reported developing the disease in Norway after purposely inhaling a large quantity of Lycoperdon spores to stop a nosebleed Lycoperdon species are sometimes used in folk medicine in the belief that their spores have haemostatic properties7 A 1997 case report discussed several instances of teenagers inhaling the spores In one severe case, the individual inhaled enough spores so as to be able to blow them out of his mouth He underwent bronchoscopy and then had to be on life support before recovering in about four weeks In another instance, a teenager spent 18 days in a coma, had portions of his lung removed, and suffered severe liver damage4 In Wisconsin, eight teenagers who inhaled spores at a party presented clinical symptoms such as cough, fever, shortness of breath, myalgia, and fatigue within a week Five of the eight required hospitalization; of these, two required intubation to assist in breathing5 The disease is rare, possibly because of the large quantity of spores that need to be inhaled for clinical effects to occur4 Lycoperdonosis also occurs in dogs; in the few reported cases, the animals had been playing or digging in areas known to contain puffballs389 Known species of puffballs implicated in the etiology of the published cases include the widespread Lycoperdon perlatum the "devil's snuff-box", L gemmatum and Calvatia gigantea, both of the Lycoperdaceae family68

Referencesedit

  1. ^ Barrios R 2008 "Hypersensitivity pneumonitis extrinsic allergic alveolitis" Dail and Hammar’s Pulmonary Pathology 3rd ed pp 650–667 ISBN 978-0-387-72113-2 
  2. ^ Peroš-Golubičić T, Sharma OP 2006 "Hypersensitivity pneumonitis" Clinical Atlas of Interstitial Lung Disease Springer pp 91–95 doi:101007/978-1-84628-326-0_16 CS1 maint: Uses authors parameter link
  3. ^ a b Alenghat T, Pillitteri CA, Bemis DA, Kellett-Gregory L, Jackson KV, Kania SA, Donnell RL, Van Winkle T 2010 "Lycoperdonosis in two dogs" Journal of Veterinary Diagnostic Investigation 22 6: 1002–1005 PMID 21088194 doi:101177/104063871002200629 CS1 maint: Uses authors parameter link
  4. ^ a b c Munson EL, Panko DM, Fink JG 1997 "Lycoperdonosis: Report of two cases and discussion of the disease" Clinical Microbiology Newsletter 19 3: 17–24 doi:101016/S0196-43999789413-5 CS1 maint: Uses authors parameter link
  5. ^ a b Taft TA, Cardillo RC, Letzer D, Kaufman CT, Kazmierczak JJ, Davis JP July 29, 1994 "Respiratory Illness Associated with Inhalation of Mushroom Spores – Wisconsin, 1994" Morbidity and Mortality Weekly Report Centers for Disease Control and Prevention 43 29: 525–526 Retrieved 2011-09-11 CS1 maint: Uses authors parameter link
  6. ^ a b Strand RD, Neuhauser EB, Somberger CF 1967 "Lycoperdonosis" New England Journal of Medicine 277 2: 89–91 PMID 6027138 doi:101056/NEJM196707132770209 CS1 maint: Uses authors parameter link
  7. ^ Henriksen NT 1976 "Lycoperdonosis" Acta Paediatrica Scandinavica 65 5: 643–645 PMID 986747 
  8. ^ a b Rubensohn M 2009 "Inhalation pneumonitis in a dog from spores of puffball mushrooms" Canadian Veterinary Journal 50 1: 93 PMC 2603663  PMID 19337622 
  9. ^ Buckeridge D, Torrance A, Daly M 2011 "Puffball mushroom toxicosis lycoperdonosis in a two-year-old dachshund" Veterinary Record 168 11: 304 PMID 21498199 doi:101136/vrc6353 CS1 maint: Uses authors parameter link


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