What happens in the lungs and what forms there are
When tiny organic particles are repeatedly inhaled, the immune system begins to perceive them as a threat. Inflammation develops in the walls of the alveoli and small bronchi with the formation of accumulations of immune cells, which disrupts the transfer of oxygen to the blood. If contact stops, the changes are reversible. With prolonged contact, inflammation gives way to scarring, the lungs lose elasticity, and fibrosis forms. There are acute forms with striking episodes, subacute and chronic forms with gradually increasing shortness of breath.
- Inflammation of the alveoli and small bronchi
- Impaired oxygen transfer to the blood
- Acute form - episodes a few hours after contact
- Subacute form - weeks and months
- Chronic form - gradual shortness of breath and fibrosis
- Reversibility of changes upon early termination of contact
Sources and risk factors
The range of possible sources is wide, and identifying them requires detailed questioning about home, work and hobbies. Classic options include working with wet hay and grain, keeping parrots and pigeons, growing mushrooms, and contact with damp wood. In urban environments, mold in the bathroom and on the walls, air conditioners and humidifiers with stagnant water, down pillows and blankets are often to blame. The frequency of contact is also important: it is not the single dose that is important, but the regularity of inhaling dust.
- Molds in damp housing
- Hay, straw, grain, flour
- Birds: parrots, pigeons, poultry
- Feather pillows and duvets
- Humidifiers, air conditioners, ventilation systems
- Professional contact with organic dust
- Regularity and duration of contact
Symptoms
In the acute form, a few hours after contact, cough, shortness of breath, chills, fever, body aches and weakness appear - the picture resembles the flu, which is why the diagnosis is often delayed. If the contact stops, the state of health returns to normal within a day or two, and when you return to the room, everything repeats. The chronic form proceeds differently: there is no fever, but shortness of breath on exertion gradually increases, a dry cough persists, and weight decreases. When listening to the lungs, the doctor often notes characteristic wheezing.
- Cough, usually dry
- Shortness of breath on exertion, then at rest
- Episodes of fever and chills after exposure
- Body aches, weakness, headache
- Improvement on holiday or outdoors
- Chronic weight loss
- Thickening of the fingertips over a long period of time
Diagnostics
The main role is played by a detailed conversation: the doctor finds out where and when complaints arise, whether there is improvement on weekends and on vacation, what birds, plants or production factors surround the person. High-resolution computed tomography shows characteristic changes in lung tissue, which often suggest a diagnosis. Spirometry reveals a decrease in volume, and measurement of diffusion capacity reveals a violation of gas exchange. If the picture is unclear, bronchoscopy is performed with examination of lavage water, and less commonly, a lung biopsy.
- Detailed history of life, work and hobbies
- High resolution CT scan of the chest
- Spirometry and lung diffusivity
- Pulse oximetry and walking test
- Complete blood count and inflammation indicators
- Specific antibodies to suspected sources
- Bronchoalveolar lavage and biopsy if unclear
Treatment and prevention
The main and mandatory step is to completely eliminate contact with the source: get rid of mold, remove birds, replace down bedding, adjust ventilation, and in case of professional exposure, change working conditions. Without this, no treatment will give lasting results. For severe symptoms, the doctor may prescribe glucocorticosteroids for a short course; in severe chronic cases, other drugs and oxygen therapy are used. Smoking cessation is required, as well as vaccination on the recommendation of a pulmonologist.
- Complete cessation of contact with the dust source
- Elimination of dampness and mold in housing
- Refusal to keep birds and down products
- Cleaning and maintenance of air conditioners and humidifiers
- Respiratory protection at work
- Glucocorticosteroids as prescribed by a doctor
- Smoking cessation and pulmonary rehabilitation