Garden Fungus Kills British Man

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.

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.

By Daniel DeNoon
Reviewed by Louise Chang
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