Parenchymal lung disease (not the airway). Causes irreversible restrictive disease (not COPD).Provoked by specific environmental irritants:
- Abrupt onset 4-8 hours after exposure
- Cough, Dyspnea, ? Fever / Nausea
- Resolves 12 hours after removal from irritant
- Long list of culprits: humidifiers, indoor pools, auto factories, saunas, printers’ & embalmers chemicals, mushrooms, etc. etc. etc.
Lung Sounds: Usually clear, sometimes rales, rarely wheezes.Imaging:
- CXR often normal
- High-Resolution CT image of choice but may be normal
- Irreversible damage may occur before seen on image
Send patients with suspect history & possible exposure to Pulmonary.
See posting Chronic Cough (end of post).