Occupational Asthma Reference

Koschela D, Stark W, Karmann F, Sennekamp J, Müller-Wening D, Extrinsic allergic alveolitis caused by misting fountains, Respir Med, 2005;99:943-947,
(Plain text: Koschela D, Stark W, Karmann F, Sennekamp J, Muller-Wening D, Extrinsic allergic alveolitis caused by misting fountains, Respir Med)

Keywords: Ultrasonic home humidifier; Misting fountain; Extrinsic allergic alveolitis; Humidifier lung; Humidifier fever, challenge test, non-occupational, histology, IgG, Acetinobacter, Bacillus, Oseudomonas, Stentrophomonas

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Recently, an increasing number of patients were presented to our clinics with febrile and respiratory symptoms associated with exposure to a new type of domestic ultrasonic humidifier.

We report on 11 patients who developed recurrent episodes of fever, cough and dyspnea after repeated exposure to ultrasonic misting fountains at home. A diagnosis of extrinsic allergic alveolitis (EAA) or toxic alveolitis was made on the basis of the history and the clinical, radiological, laboratory and immunological findings. Eight patients were subjected to inhalative challenge tests with their own ultrasonic misting fountains, and all of them exhibited positive reactions.

Nine patients were diagnosed with an EAA (humidifier lung) and two patients with a toxic alveolitis (humidifier fever).

This study demonstrates the potential for ultrasonic misting fountains to cause illness in the home. In view of the increasing popularity of these devices, humidifier lung and humidifier fever should be considered in the differential diagnosis of patients with unexplained pulmonary or flu-like illnesses with fever.

Full Text


Precipitins were prresent to humidifier water in 45% but all negative to individual organisms. An ELISA IgG was present in 4/9 to an individual organism including Stenotrophomonas, Bacillus, Pseudomonas and Mucores

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