Hypersensitivity Pneumonitis Caused by a Home Ultrasonic Humidifier Contaminated with Candida guilliermondii

Abstract

We herein report the first documented case of acute hypersensitivity pneumonitis in which Candida guilliermondii was the possible causative organism. A young Japanese woman presented to our hospital with relapsing respiratory symptoms accompanied by high fever. A detailed interview revealed that the onset of the symptoms occurred shortly after using a humidifier in her home. Her symptoms showed spontaneous improvement soon after admission, and an examination of her bronchoalveolar lavage fluid revealed the specific infiltration of inflammatory cells, which predominantly consisted of lymphocytes. Precipitin testing showed a positive reaction to C. guilliermondii, which was isolated from the home humidifier. Repeated history taking is essential for diagnosing occult respiratory disorders.

Keywords: Candida guilliermondii; hypersensitivity pneumonitis; pleuritis; recurrent pneumonia.

Figure 1.

The radiological findings on admission. Chest X-ray (A) and computed tomography (B, C) showing ground-glass opacities, reticular shadows, and consolidation in the bilateral lower lungs.

Figure 2.

The precipitin reaction by the Ouchterlony method. S, The patient’s serum; 1, Candida guilliermondii; 2, 4, 6, Cephalosporium acremonium; 3, Candida parapsilosis; 5, Candida lipolytica. The arrowhead shows the precipitation line between the patient’s serum and C. guilliermondii.