A case report in this week's edition of The Lancet describes a 47-year old man who was admitted to hospital with severe chest pain, worse on breathing in, a cough and increasing shortness of breath. He smoked 10 cigarettes a day and worked as a welder.
He was treated for a community acquired pneumonia, but did not improve. Further investigations showed that his lungs contained infiltrates that contained spores of the fungus Aspergillus fumigatus. His symptoms had apparently started less than 24 hours after he had scattered rotting tree and plant mulch on his garden and he reported that he had been engulfed in clouds of dust. Despite being aggressively treated with an antifungal, the man unfortunately died.
The authors of the case study point out that aspergillus spores are often found in decaying plant material and inhaling these spores can cause serious lung problems. While it is unusual for someone who is not immunosupressed to be so seriously affected, the authors suggest that it may have been the smoking and welding that caused damage to the lungs that allowed the infection to take hold. In those who are immunosupressed, for example through HIV infection, it is probably safer to allow someone else to scatter mulch on the garden.
