Cockatiel-Induced Hypersensitivity Pneumonitis James D. McCluskey,1,2 Robert R. Haight,1,2 and Stuart M. Brooks1,2,3 1Department of Internal Medicine, Division of Pulmonary, Critical Care, and Occupational Medicine, College of Medicine; 2Department of Environmental and Occupational Health, College of Public Health, and 3Department of Internal Medicine, Division of Allergy and Clinical Immunology, College of Medicine, University of South Florida, Tampa, Florida, USA Abstract University of South Florida College of Medicine and University of South Florida College of Public Health Diagnosing an environmental or occupationally related pulmonary disorder often involves a process of elimination. Unlike commonly diagnosed conditions in other specialties, a cause-and-effect relationship may be implied, yet other factors such as temporality and biologic plausibility are lacking. Our patient was referred with a suspected work-related pulmonary disorder. For several years, she had suffered with dyspnea on exertion and repeated flulike illnesses. She worked at an automobile repair garage that performed a large number of emission tests, and there was concern that her workplace exposures were the cause of her symptoms. After a careful review of her history, physical examination, and laboratory testing, we came to the conclusion that she had hypersensitivity pneumonitis related to pet cockatiels in her home. Clinical points of emphasis include the importance of a complete environmental history and careful auscultation of the chest when performing the physical examination. In addition, we encountered an interesting physical diagnostic clue, a respiratory sound that assisted with the eventual diagnosis. Key words: bird-breeder's lung, bird breeding, cockatiels, hypersensitivity pneumonitis, inspiratory squawk, lung, precipitin antibodies, respiratory sounds. Environ Health Perspect 110:735-738 (2002) . [Online 5 June 2002] http://ehpnet1.niehs.nih.gov/docs/2002/110p735-738mcclusky/abstract.html The full version of this article is available for free in HTML or PDF formats. |