Hypersensitivity Pneumonitisamong Workers Cultivating<i>Tricholoma conglobatum</i> (Shimeji)

Abstract

We report five cases of hypersensitivity pneumonitis among workers cultivating Tricholoma conglobatum (shimeji). After having worked for 5 to 20 years, they began to notice symptoms of cough, sputum, and dyspnea. They were diagnosed as having a hypersensitivity pneumonitis based on clinical features, bronchoalveolar lavage and transbronchial lung biopsy. By the double immunodiffusion test, precipitating lines between shimeji spore antigen and sera were observed in all of the patients. By enzyme-linked immunosorbent assay, the antibody activities against shimeji and three species of fungi (Cladosporium sphaerospermum, Penicillium frequentans, and Scopulariopsis species) were significantly higher in the sera of the patients than in those of normal subjects who were cultivating shimeji. Although it is not clear what causes this disease, these findings may be helpful in determining the specific antigen.

Hypersensitivity Pneumonitis: A Historical, Clinical, and Radiologic Review

“…For example, mushroom worker's lung may be caused either by inhalation of thermophilic actinomycetes from compost or inhalation of mushroom spores (15). Furthermore, hypersensitivity pneumonitis may result from exposure to multiple agents present in the same environment, as is suggested by the simultaneous presence of antibodies to several organisms in some patients (16,17).…”

Hypersensitivity Pneumonitis Associated with Mushroom Worker’s Lung: An Update on the Clinical Significance of the Importation of Exotic Mushroom Varieties

“…Ta-ble 1 details and reviews several species and antigens which have not been previously reported as causal agents of MWL [4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25]. Of note is the case report of HP in a 61-year-old Japanese man [7] who was exposed for 12 years to Shiitake mushrooms and then developed an adenosquamous carcinoma lesion (stage 1B) in his left lung.…”

Exposure assessment in hypersensitivity pneumonitis: a comprehensive review and proposed screening questionnaire

“…Both types of organism may be found in moist hay or straw, grain bins, animal feed, silage and manure, as well as on contaminated crops such as onion, potato and corn [38][39][40][41]. Reported causative fungal organisms have included W. sebi, Aspergillus, E. amstelodami, Penicillium, Lichtheimia corymbifera, Fusarium, Absidia corymbifera, Cladosporium, Alternaria alternata and Trichosporon, in decreasing frequency [39,[42][43][44][45][46][47][48].…”

“…Cork material has been reported as contaminated with Aspergillus , Penicillium , Rhizopus and Mucor , leading to a specific type of HP termed “suberosis” [ 51 , 52 ]. Mushroom farms have also been the setting for HP, with reported precipitating antigens related to Penicillium , Cladosporium, Scopulariopsis and A. alternata [ 46 , 47 , 53 ].…”

“…Other rare or uncommon sources of exposure leading to HP are further highlighted. Mushroom spores were the most commonly reported organic antigen causing HP outside of other fungal and bacterial species [ 47 , 79 , 80 ]. Precipitating antibodies against hay have also been reported [ 44 ].…”