Possible exposures: occupational, domestic, sick building
Features:
(1) presentation with chronic cough and/or shortness of breath
(2) evidence of hypersensitivity pneumonitis
(3) exposure to a device producing water vapor, such as a humidifier
(4) contamination of the water reservoir with micro-organisms, identified by culture
(5) evidence of allergy to one or more of organisms identified in culture of the water reservoir
(6) improvement on decontamination of the device or discontinuation of the exposure
(7) exclusion of other causes of hypersensitivity pneumonitis, chemical pneumonitis or pneumonia
Antigen sources may include:
(1) atypical mycobacteria such as Mycobacterium gordonae
(2) Gram-negative bacteria such as Pseudomonas or Klebsiella species
(3) thermophilic actinomycetes
(4) fungi
(5) yeast
