Cheese washer lung

Classification according to ICD-10
J67	Allergic alveolitis due to organic dust
J67.8	Cheese washer lung
ICD-10 online (WHO version 2019)

As cheese scrubber lung (including cheese scrubber disease , syn. : Eng. Cheese washer's lung ) is a alveolitis exogenous - allergic designated cause. It was mainly observed in Switzerland with traditional cheese salters. The cheese washer lung is a reportable occupational disease .

root cause

The cause is an allergic reaction to mold spores ( Penicillium casei ) and mites in the cheese rind in people who clean mold-infested cheese wheels with salt water.

Symptoms

The symptoms are initially flu-like symptoms such as fever, dry cough, difficulty breathing or headache. The acute illness is mostly bland and reversible, so it usually subsides quickly if there is no further exposure. If there is no allergen avoidance, the symptoms can persist; in the further course the transition to pulmonary fibrosis is possible.

Diagnosis

As with other exogenous allergic alveolites, the acute disease presents itself as auscultation with rattling noises when inhaled. The lung function shows the picture of a restrictive ventilation disorder, in the laboratory leukocytosis and an increased rate of sedimentation can be determined. The bronchoalveolar lavage allows a sensitive diagnosis : in the acute stage there are predominantly neutrophilic granulocytes , in the chronic stage mainly lymphocytes .

therapy

The patient should avoid contact with the allergen, a change of profession should be sought. If this is not possible, respiratory protection must be worn. In the chronic form, administration of cortisone can be considered; Furthermore, therapy for pulmonary fibrosis should be given, if this has occurred.

literature

Minnig, Rudolf Oswald: The "cheese washing disease": Immunological and epidemiological studies. , 1973, Bern

Web links

Federal Ministry of Labor: Leaflet on BK No. 4201: Exogenous allergic alveolitis (PDF), Leaflet for medical examination, 1989

Individual evidence

↑ Martin Weidenbörner: Lexicon of food mycology . Springer-Verlag, March 7, 2013, ISBN 978-3-642-57058-2 , p. 71.
↑ Wolfgang Mücke, Christa Lemmen: Molds: occurrence, health hazards, protective measures . ecomed-Storck GmbH, 2004, ISBN 978-3-609-68001-9 , p. 60 f.
^ Richard Mitchell et al .: Robbins Basic Pathology , 8th ed., P. 503, ISBN 978-1-4160-2973-1 .
↑ Pschyrembel Online: cheese scrubber lung
↑ ^a ^b ^c ^d ^e Gerd Herold: Internal Medicine 2017 . Cologne 2017, ISBN 978-3-9814660-6-5 , pp. 398-399 .

[Weidenbörner2013-1] Martin Weidenbörner: Lexicon of food mycology . Springer-Verlag, March 7, 2013, ISBN 978-3-642-57058-2 , p. 71.

[MückeLemmen2004-2] Wolfgang Mücke, Christa Lemmen: Molds: occurrence, health hazards, protective measures . ecomed-Storck GmbH, 2004, ISBN 978-3-609-68001-9 , p. 60 f.

[basic-3] Richard Mitchell et al .: Robbins Basic Pathology , 8th ed., P. 503, ISBN 978-1-4160-2973-1 .

[pschy-4] Pschyrembel Online: cheese scrubber lung

[Herold-5] Gerd Herold: Internal Medicine 2017 . Cologne 2017, ISBN 978-3-9814660-6-5 , pp. 398-399 .