| Lycoperdonosis | |
|---|---|
 | |
| Puffball spores seen withscanning electron microscopy; 5000x magnification | |
| Specialty | Pulmonology |
Lycoperdonosis is arespiratory disease caused by the inhalation of large amounts ofspores from maturepuffballs. It is classified as ahypersensitivity pneumonitis (also called extrinsic allergic alveolitis)—an inflammation of thealveoli within the lung caused byhypersensitivity to inhaled natural dusts.[1] It is one of several types of hypersensitivity pneumonitis caused by different agents that have similar clinical features.[2] Typical progression of the disease includes symptoms of acold hours after spore inhalation, followed bynausea, rapid pulse, crepitantrales (a sound like that made by rubbing hairs between the fingers, heard at the end of inhalation), anddyspnea. Chestradiographs reveal the presence oflung nodules.[3] The early symptoms presented in combination with pulmonary abnormalities apparent on chest radiographs may lead to misdiagnosis of the disease astuberculosis,histiocytosis, orpneumonia caused byPneumocystis carinii. Lycoperdonosis is generally treated withcorticosteroids, which decrease theinflammatory response; these are sometimes given in conjunction withantimicrobials.[4][5]
The disease was first described in the medical literature in 1967 by R.D. Strand and colleagues in theNew England Journal of Medicine.[6] In 1976, a 4-year-old was reported developing the disease in Norway after purposely inhaling a large quantity ofLycoperdon spores to stop a nosebleed.Lycoperdon species are sometimes used infolk medicine in the belief that their spores havehaemostatic properties.[7] A 1997 case report discussed several instances of teenagers inhaling the spores. In one severe case, the individual inhaled enough spores so as to be able to blow them out of his mouth. He underwentbronchoscopy and then had to be onlife support before recovering in about four weeks. In another instance, a teenager spent 18 days in a coma, had portions of his lung removed, and suffered severeliver damage.[4] InWisconsin, eight teenagers who inhaled spores at a party presented clinical symptoms such as cough,fever,shortness of breath,myalgia, and fatigue within a week. Five of the eight required hospitalization; of these, two requiredintubation to assist in breathing.[5] The disease is rare, possibly because of the large quantity of spores that need to be inhaled for clinical effects to occur.[4] Lycoperdonosis also occurs in dogs; in the few reported cases, the animals had been playing or digging in areas known to contain puffballs.[3][8][9] Known species of puffballs implicated in theetiology of the published cases include the widespreadLycoperdon perlatum (the "devil's snuff-box",L. gemmatum) andCalvatia gigantea, both of the familyLycoperdaceae.[6][8]