Hypersensitivity pneumonitis against the background of the use of organic substances, probably mustard powder (clinical case)

Abstract

We describe a clinical case of hypersensitivity pneumonitis against the background of the use of organic substances, probably mustard powder.Patient K. is 18 years old and lives in the city. The disease began on 01.11.2022, with complaints of cough with difficult secretion of thick sputum, shortness of breath with slight physical exertion, an increase in body temperature to 37.5 °C, a feeling of palpitations. Complaints were observed for about three weeks and increased in dynamics. Consulted a pulmonologist at a private medical center, where a diagnosis of allergic bronchitis was made and treatment was prescribed, which did not have a positive effect. On 21.11.2022, the family doctor referred him for an X-ray examination, where pathological changes in the lungs were detected. The patient was referred to a pulmonologist for consultation, and a computed tomography (CT) of the chest was also performed. Changes characteristic of hypersensitivity pneumonitis were detected, hospitalized in the pulmonology department of the Ternopil Regional Phthisiopulmonological Medical Center. It is known from the anamnesis that for about three months he worked in the production of food products where mustard powder was used, he did not use respiratory protection means.Additional examination methods were carried out. Bronchoscopy, conclusion — Catarrhal laryngitis, diffuse bilateral catarrhal tracheobronchitis. Computed tomography of the chest organs dated 22.11.2022, the conclusion is that the picture of the dissemination syndrome in the lungs is more characteristic of acute hypersensitivity pneumonitis. The patient was consulted by a cardiologist. The clinical diagnosis «Hyper­sensitive pneumonitis against the background of the use of organic substances, probably mustard powder, subacute form, diagnosed for the first time. Pulmonary insufficiency of the 2nd degree. Idiopathic mitral valve prolapse. Metabolic cardiomyopathy. Heart failure of the 0th stage». Treatment is prescribed. 09.12.2022 discharged for outpatient treatment with improvement. According to the data of the control examination (CT dated 09.01.2023) dynamics of partial resorption of hypersensitivity pneumonitis.