June 12, 2008 -- A fungal lung infection, aspergillosis, killed a healthy 47-year-old British man who inhaled dust stirred up while mulching his garden.
Aspergillus fungus is commonly found in rotting plant material, and that's where the man apparently inhaled the fungal spores.
"His symptoms had started less than 24 hours after he had dispersed rotting tree and plant mulch in the garden, when clouds of dust had engulfed him," report Katherine Russell, MBBS, and colleagues at Wycombe Hospital in Buckinghamshire, England.
Unfortunately, by the time the man's doctors realized he had a fungal infection and began appropriate treatment, it was too late to save him.
It's hard to totally avoid aspergillus spores. That makes the fungus a serious threat to transplant patients, to people with immune deficiencies, to patients with lung disease, and to other critically ill patients.
But it's unusual for the bug to colonize people with healthy immune systems and healthy lungs. The British victim smoked a half pack of cigarettes a day and worked as a welder, so it's possible he had undetected lung damage. However, a similar fatal case -- in a healthy British gardener -- was reported in 1989.
Aspergillus can cause several different types of disease:
- An allergic reaction in the lungs -- allergic bronchopulmonary aspergillosis -- mostly seen in people with cystic fibrosis or asthma.
- Fungus balls -- aspergillomas -- usually in the lung.
- A long-lasting lung infection called chronic necrotizing aspergillosis, usually seen in patients with chronic lung disease or immune deficiency.
- Acute, fast-moving infection -- invasive pulmonary aspergillosis -- that usually affects the lungs but which can spread to any part of the body, including the brain.
It was this last kind of infection that killed the British man.
Aspergillus infections can be treated with antifungal drugs. But diagnosis is tricky, and treatment is most effective when started soon after infection.
Symptoms of aspergillosis include fever, chest pain, cough, and shortness of breath. If you have these symptoms, especially in the days or weeks after serious dust exposure, you should see a doctor right away.
Russell and colleagues report their findings in the June 14 issue of The Lancet.