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Farmer's Lung in Maryland: Clinical, Microbiological, and Immunological Studies

Ann Intern Med. 1966;64(4):860-872. doi:10.7326/0003-4819-64-4-860
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Farmer's lung is an occupational disease of agricultural workers who are exposed to moldy forage (principally hay and silage). Clinically, it is characterized by dyspnea, cough, and fever, the development of a granulomatous interstitial pneumonitis, and decreased pulmonary diffusing capacity (1, 2). Recent studies in Great Britain (3) and in Wisconsin (4, 5) have indicated that the principal etiologic agent may be an antigen derived from one or more thermophilic actinomycetes, and the evidence suggests that the disease is a hypersensitivity reaction to inhalation of the antigen rather than an infection. Epidemiologic studies indicate that farmer's lung is prevalent in


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