Ask patients with hypersensitivity pneumonitis whether they play a wind instrument

The cause for hypersensitivity pneumonitis is often difficult to find, recent papers provide evidence that the cause may be from microbiologically contaminated wind instruments, including trombones, saxophones and most recently bagpipes. There is a case report of fatal Hypersensitivity Pneumonitis in a bagpipe player, whose bagpipes yielded Penicillium species, Fusarium oxysporum, Rhodotorula mucilaginosa and Trichosporon mucoides. The diagnosis was made from a history of improvement while away from home and bagpipes for 3 months in Australia, and deterioration on return. There was no physiological confirmation of these changes or search for precipitating antibodies, which would have helped confirm the causal relationship between the bagpipes and the HP.

References

	King J, Richardson M, Quinn A, Holme J, Chaudhuri N, Bagpipe lung; a new type of interstitial lung disease?, Thorax, 2017;72:380-382,doi.org/10.1136/thoraxjnl-2016-208751

	Metzger F, Haccuria A, Reboux G, Nolard N, Dalphin J, Vuyst PD, Hypersensitivity Pneumonitis Due to Molds in a Saxophone Player, Chest, 2010;138:724-726,10.1378/chest.09-2991

	Metersky ML, Bean SB, Meyer JD, Mutambudzi M, Brown-Elliott BA, Wechsler ME, Wallace RJ, Trombone Player’s Lung: A Probable New Cause of Hypersensitivity Pneumonitis, , Chest, 2010;138:754-756,10.1378/chest.10-0374

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