Pigeon Breeder's Lung Disease and Interstitial Pulmonary Fibrosis

TO THE recognition that inhalation of organic dusts can provoke interstitial reactions such as farmer's lung,1bagassosis,2,3maple bark-stripper's lung,4and sequoiosis5has been added the recent discovery that organic dusts from birds can initiate a similar reaction most often seen in pigeon breeders.6-9Fever, chills, and chest pain occur four to six hours after inhalation of pigeon coop dust. Dyspnea, cough, and weight loss develop gradually. Most investigators have described a restrictive ventilatory defect and diminished carbon monoxide diffusing capacity as characteristic of the physiologic impairment. Precipitins to pigeon antigens have been noted in sera of these patients, but their significance is not clearly understood.10,11Lung biopsy has revealed interstitial mononuclear cell infiltration. This is a report of the pulmonary pathophysiological findings in a 15-year-old boy at the time of diagnosis of pigeonbreeder's lung disease and two years later. Examination of a lung