Bagpipe lung; a new type of interstitial lung disease?

Musical Instrument-Associated Health Issues and Their Management

“…In addition, there have been case reports of HP occurring in saxophonists (Lodha et al 1988;Metzger et al 2010;Rackley and Meltzer 2011), a trombonist (Metersky et al 2010), and a bagpiper (King et al 2017). In the latter-most case, a 61-year-old man who played the bagpipes daily was referred to an interstitial lung disease clinic with a 7-year history of dry cough and progressive dyspnea on exertion with poor exercise tolerance.…”

“…He was prescribed 2 mg/kg azathioprine with prednisolone, but continued to play the bagpipes daily. Five months after the initial visit to the interstitial lung disease clinic, he was hospitalized due to deterioration of symptoms and died one month later (King et al 2017).…”

“…In another case study, cultures of the biofilm found inside the patient's trombone revealed large numbers of Mycobacterium chelonae-abscessus group and Fusarium sp., as well as minute quantities of Stenotrophomonas maltophilia and Escherichia coli (Metersky et al 2010). The study by King et al (2017) detected a wide range of fungi in the patient's bagpipes that included Paecilomyces variotii, Fusarium oxysporum, Penicillium sp., Rhodotorula mucilaginosa, Trichosporon mucoides, pink yeast, and Exophiala dermatitidis. The various types of potentially pathogenic fungi sampled from various wind instruments are summarized in Table 1.…”

“…However, this can be problematic in professional musicians who rely on these instruments to make a living. In particular, there may be an overall lack of education provided to students on the correct methods to clean wind instruments (King et al 2017). The mouthpieces of instruments can harbor thousands of microorganisms that survive for several days.…”

“…However, this activity is also responsible for numerous health issues that range from mild disorders to potentially fatal conditions. A recent report by King and coworkers described a fatal case of hypersensitivity pneumonitis (HP) in a bagpiper, which provides a stark reminder of the risk of health issues associated with musical instruments (King et al 2017).…”