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Hypersensitivity Pneumonitis Caused by Cladosporium in an Enclosed Hot-Tub Area

ROBERT L. JACOBS, M.D.; RICHARD E. THORNER, M.D.; JOHN R. HOLCOMB, M.D.; LEIGH ANNE SCHWIETZ, M.D.; and FRANK O. JACOBS, B.S.
[+] Article and Author Information

The opinions or assertions contained here are the private views of the authors and are not to be construed as official or as reflecting the view of The Department of the United States Air Force or The Department of Defense.

Presented March 1986 at the Annual Meeting of the American Academy of Allergy and Immunology, New Orleans, Louisiana.

▸Requests for reprints should be addressed to Robert L. Jacobs, M.D.; The Seville Office Park, 8279 Fredericksburg Road; San Antonio, TX 78229.


San Antonio and Lackland Air Force Base, Texas


Ann Intern Med. 1986;105(2):204. doi:10.7326/0003-4819-105-2-204
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A 48-year-old woman had an 18-month history of malaise and chronic cough with intermittent episodes of fever, chills, and pneumonic infiltrates. Transbronchial biopsy findings were consistent with hypersensitivity pneumonitis. Cultures of fungus from a hot-tub room in her home were positive for Cladosporium species. Serum precipitins were weakly positive for Cladosporium cladosporioides. Removal of the patient from the home environment led to a resolution of symptoms within 1 week. Within 4 hours of re-exposure to the hot-tub room, symptoms and signs and changes in leukocyte count and spirometric values again occurred. Bronchial provocation with a commercial extract of C. cladosporioides led to a similar pattern 5 hours after the initial challenge. This case identifies a previously unreported etiologic agent and environmental site for hypersensitivity pneumonitis.

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