Bird ownership and pulmonary outcomes apart from hypersensitivity pneumonitis in European older adults.

BACKGROUND: Exposure to birds has been linked with several lung pathologies and especially hypersensitivity pneumonitis, but discordant literature exist on the potential effects of this exposure on other respiratory pathologies. AIM: This study aims to examine the associations between bird ownership and asthma, lung cancer, and chronic obstructive pulmonary disease (COPD) in older European adults. METHODS: A total of 28,109 participants from the Survey of Health, Ageing, and Retirement in Europe were employed and analyzed with multivariate logistic regressions. RESULTS: No association was found with asthma or lung cancer. Bird ownership increased the odds for COPD diagnosis (OR=1.30; 95 % CI: 1.12-1.51) and more so in males (OR=1.53; 95 % CI: 1.25-1.87) after adjustment for demographic, respiratory, lifestyle, and socioeconomic factors. Male bird owners who smoke had an even more increased risk compared to non-smokers, as did those who lived in multi-person households compared to those living alone. CONCLUSION: Bird ownership may be positively associated with COPD in older European males.

Severe Chlamydia psittaci pneumonia: clinical characteristics and risk factors.

BACKGROUND: Psittacosis ranges from a mild illness to fulminant severe pneumonia with multi-organ failure. It's crucial to understand the clinical characteristics and identify risk factors for a better outcome. METHODS: We conducted a retrospective analysis designed to identify risk factors for severe Chlamydia psittaci pneumonia (C. psittaci pneumonia) by comparing the clinical characteristics of patients with severe and less severe forms of the disease. Epidemiological, clinical, laboratory, computed tomography (CT) imaging, and outcome data were collected. RESULTS: We enrolled 27 patients with C. psittaci pneumonia, with a median age of 63 (range, 47-82) years, and 23 of whom (85.2%) had a history of avian exposure. Dyspnea was seen in 15 patients with severe C. psittaci pneumonia (100%), and four in 12 non-severe patients (33.3%) (P<0.01). Compared to non-severe patients, those with severe C. psittaci pneumonia had significantly higher levels of procalcitonin, urea nitrogen, lactate dehydrogenase, creatine kinase (CK), B natriuretic peptide (BNP), myoglobin, IL-6, and IL-10, as well as lower lymphocyte and CD8+ T cell counts, and PaO2/FiO2 ratio. Among patients with severe infection, CT showed that 46.7% had multi-lobar (more than two lobes) pneumonia, whereas its incidence was 0% in non-severe patients (P=0.01). Multivariate analysis revealed that the independent risk factors associated with severe C. psittaci pneumonia were abnormal CK (OR 15.2, 95% CI: 1.1-204.8, P=0.04) and BNP (OR 22.3, 95% CI: 1.8-281.9, P=0.02). CONCLUSIONS: A history of prior avian exposure in middle-aged patients should serve as a clue in the diagnosis of C. psittaci pneumonia, and patients with its severe form are more likely to develop dyspnea and progress into respiratory failure, with involvement of multiple lung lobes. Abnormal CK and BNP levels are risk factors associated with severe C. psittaci pneumonia.

Bird Fancier's lung: An underdiagnosed etiology of dyspnea.

Bird Fancier's Lung is a type of hypersensitivity pneumonitis, an immunologically mediated lung disease due to repetitive exposure of air-borne avian antigen. This was first described in 1965 and is known as one of the most common causes of hypersensitivity pneumonitis. This case highlights this underdiagnosed etiology of dyspnea, disease presentation and exposure variability, and methods of diagnosis.

Enclosure design for flock-level, chronic exposure of birds to air contaminant mixtures.

The objective of this study was to design an enclosure suitable for studying the ecotoxicological effects of vehicle emissions on groups of wild birds without compromising welfare. Two, adjacent enclosures sheltered from sunlight, wind and rain, were bird-proofed and wrapped with thick polyethylene sheeting. Emissions were directed into the treatment enclosure from the exhaust of a light-duty gasoline truck, using flexible, heat-proof pipe, with joins sealed to prevent leakage. During active exposure, the engine was idled for 5 h/day, 6 days/week for 4 weeks. Fans maintained positive pressure (controls) and negative pressure (treatment), preventing cross-contamination of enclosures and protecting investigators. Four sets of passive, badge-type samplers were distributed across each enclosure, measuring nitrogen dioxide, sulfur dioxide and volatile organic compounds (NO2, SO2 and VOCs, respectively), and were complemented by active monitors measuring VOCs and particulate matter (2.5 µm diameter, PM2.5). We found that the concentrations of NO2, SO2 and PM2.5 were not different between treatment and control enclosures. Volatile organic compounds (e.g. benzene, toluene, ethylbenzene and xylenes) were approximately six times higher in the treatment enclosure than control (13.23 and 2.13 µg m-1, respectively). In conclusion, this represents a successful, practical design for studying the effects of sub-chronic to chronic exposure to realistic mixtures of vehicle exhaust contaminants, in groups of birds. Recommended modifications for future research include a chassis dynamometer (vehicle treadmill), to better replicate driving conditions including acceleration and deceleration.

A case report of acute fibrinous and organizing pneumonia with pneumothorax and avian exposure history.

Acute fibrinous and organizing pneumonia (AFOP) is an uncommon variant of acute lung injury. Here, we report a patient with AFOP and a previously unreported condition, pneumothorax. After our experience with this case, we suggest that exposure to birds may be associated with AFOP; pneumothorax can develop in patients with AFOP; and glucocorticoids are very effective for treating AFOP.

Opportunistic Pulmonary Bordetella hinzii Infection after Avian Exposure.

We report 2 cases of pulmonary Bordetella hinzii infection in immunodeficient patients. One of these rare cases demonstrated the potential transmission of the bacteria from an avian reservoir through occupational exposure and its persistence in humans. We establish bacteriologic management of these infections and suggest therapeutic options if needed.