(aka Pulmonary Mycotoxicosis, Silo Unloader’s Syndrome, Mill Fever)
Exposure
- Cotton Mill Exposure
- Large outbreak has been reported in stained cotton mattress workers
- Silo Exposure
- Industrial Agriculture
- Animal Farming: with confinement
Physiology
- Inhalational Exposure to Thermophilic Bacteria and Fungal Spores: these can contaminate wood chips, straw, silage, grains, flour, and textile raw materials
- Possibly cytokine-mediated
Diagnosis
- CXR/Chest CT: usually normal (if infiltrates are present, should suggest alternative diagnosis)
- CBC: leukocytosis may be seen
- ABG: hypoxemia is usually absent
- FOB: marked influx of neutrophils
Clinical
(onset of symptoms 4-8 hrs after acute inhalation of dust)
- Mild Dyspnea (see Dyspnea, [[Dyspnea]])
- Cough (see Cough, [[Cough]])
- Fever (see Fever, [[Fever]])
- “Monday Morning Fever”: tachyphylaxis (blunted response) may occur after repeated exposures throughout the week, so symptoms are worse on first day of the workweek
- Flu-Like Syndrome: malaise, chills, myalgias
Treatment
- Self-Limited: usually spontaneously resolves within 12-48 hrs
References
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