[Humidifier-associated disease in the general population]. / Befeuchterassoziierte Erkrankungen bei der Allgemeinbevölkerung -- Eine retrospektive Untersuchung.

BACKGROUND AND OBJECTIVE: Recently an increasing number of patients presented with febrile and respiratory symptoms associated with exposure to a new type of domestic ultrasonic humidifier. PATIENTS AND METHODS: We report on 14 patients (5 females, 9 males; average age 42.5 17.4 years) with recurrent episodes of fever, cough and dyspnea after repeated exposure to ultrasonic misting fountain at home. RESULTS: A diagnosis of extrinsic allergic alveolitis (humidifier lung: 12 patients) or toxic alveolitis (humidifier fever: 2 patients) was made on the basis of the history and the clinical, radiological, laboratory and immunological findings. 10 patients had a partial respiratory insufficiency at rest or on exercise, 9 had a restrictive ventilatory abnormality. The chest x-ray was abnormal in 7 patients. Of 8 patients in whom computed tomography was done 6 had typical changes of an exogenous allergic alveolitis. Bronchoalveolar lavage revealed lymphocytic alveolitis in 8 patients. In 12 patients bacteria, moulds and/or yeasts were demonstrated in the humidifier fluid which they had used. 13 patients had IgG antibodies to the humidifier fluid. 8 patients were subjected to inhalative challenge tests to their own ultrasonic misting fountain: all of them had positive reactions. CONCLUSIONS: These cases demonstrate the potential of ultrasonic humidifying devices to cause illness in the home. In view of their increasing popularity, humidifier lung and humidifier fever should be considered in the differential diagnosis of patients with unexplained pulmonary or flu-like illness with fever.

[A comparison of high resolution computerized tomography and magnetic resonance imaging in the evaluation of allergic bronchopulmonary aspergillosis]. / Bildgebende Diagnostik der allergischen bronchopulmonalen Aspergillose: Vergleich von hochauflösender Computertomographie und Kernspintomographie.

Apart from serologic markers structural changes of bronchi and adjacent lung tissue are key factors determining the diagnosis and course of allergic bronchopulmonary aspergillosis (ABPA). Due to problems relating to procedural hazards and radiation exposure using bronchography and computerized tomography we evaluated the efficacy of magnetic resonance imaging of the lung in ABPA. Direct comparison of high resolution computerized tomography (HR-CT) and magnetic resonance imaging (MR) in 5 patients with ABPA revealed that image resolution and data acquisition of present MR technique are insufficient to accurately delineate the extent and activity of structural damage of bronchi and adjacent lung tissue. Although major bronchiectasis may be identified, MR was unable to demonstrate even extensive patchy infiltrates seen in high resolution computerized tomography. At present, magnetic resonance imaging cannot be recommended for determining diagnosis or course of ABPA.