Bronchial asthma and dermatitis due to spiramycin in a chick breeder

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Abstract
A case of bronchial asthma and dermatitis due to spiramycin is described in a non-atopic woman who worked as a chick breeder and handling poultry feed containing antibiotic or chemoterapic drugs including spiramycin, chlortetracycline and sulfadimethoxine. Patch tests showed a vigorous delayed reaction to spiramycin. Inhalation challenge test with the chick feed containing spiramycin reproduced symptoms of late asthmatic response (FEV1 [forced expiratory volume at 1 s] fell by 14% and FEF25-75 [forced expiratory flow] by 25% within the 4th and 6th h) with leukocytosis. No significant modification of FEV1 and FEF25-75 was observed within 24 h after challenge with chick feeds containing other antibiotic or chemotherapeutic agents but not spiramycin. On leaving her job, the patient had no further skin reactions or bronchial asthma episodes. Allergic reactions to a chemical product may involve type III and IV hypersensitivity.