Asthma and extrinsic allergic alveolitis due to Merulius lacrymans

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Abstract
A teacher with breathlessness of insidious onset developed acute symptoms on returning home following his discharge from the hospital. His flat had extensive dry rot (M. lacrymans). Precipitins and specific Ig[immunoglobulin]E and IgG antibody against M. lacrymans were present and intracutaneous testing gave a typical dual skin reaction. Pulmonary physiology demonstrated airflow obstruction with a low DLCO [diffusing capacity of the lung for carbon monoxide] and KCO, and a chest X-ray showed diffuse micronodular shadowing, maximal in the mid-zones. Inhalation challenge testing provoked a combined asthmatic reaction without a change in DLCO. Rapid clinical recovery and more gradual radiographic and physiological improvement followed cessation of exposure to the antigen.