Inhalation Fever

 

DISEASE NAME

DESCRIPTION

Metal fume fever

 
Symptoms: flu-like illness with a metallic taste in the mouth, throat irritation, and dry cough;
Signs: leucocytosis (high white blood cell count) is common; normal chest x-ray;
Onset after exposure: 3-10 hours;
Heavy exposure to: zinc oxide fume or dust, e.g., after welding or flame cutting of galvanized steel, high temperature zinc coating processes, or metal pouring in brass foundries; (Brass is an alloy of copper and zinc.)
Resolution: spontaneously within 48 hours;
Comments: After an episode, there is a temporary period of tolerance for a day or two afterwards. Copper and magnesium fume can also cause metal fume fever. It is important to distinguish metal fume fever (white zinc fume) from cadmium pneumonitis (yellow cadmium fume). [Rosenstock, p. 955]

Polymer fume fever

 
Symptoms: flu-like illness with chest tightness and mild cough;
Signs: leucocytosis; normal chest x-ray;
Onset after exposure: 4-8 hours;
Heavy exposure to: pyrolysis products of polytetrafluoroethylene (PTFE, trade names Fluon, Teflon, Halon);
Resolution: within 48 hours;
Comments: Polymer fume fever occurs when PTFE is heated above 300o C. When PTFE is heated above 450o, the pyrolysis products are different and may cause acute lung injury if controls to enclose the fume have not been installed.

Humidifier fever

 
Symptoms: flu-like illness;
Signs: leucocytosis; normal chest x-ray;
Onset after exposure: 4-8 hours;
Heavy exposure to: bioaerosols from air conditioning and humidifier systems;
Resolution: spontaneously within two to three days;
Comments: associated with stagnant water and forced-air ventilation systems;

Organic dust toxic syndrome (ODTS)

 
Symptoms: flu-like illness with cough preceded by eye and nasal irritation;
Signs: leucocytosis; normal chest x-ray;
Onset after exposure: 4-8 hours;
Heavy exposure to: dusts from organic matter such as moldy hay, silage, compost or wood chips;
Resolution: within two to three days;
Comments: As for other inhalation fevers, the treatment is supportive only.

Grain fever

 
Symptoms: flu-like illness;
Signs: leucocytosis; normal chest x-ray;
Onset after exposure: 4-8 hours;
Heavy exposure to: grain dust;
Resolution: within two to three days;
Comments: Grain dust contains bacterial endotoxins, storage mites and fungi.

Mill fever

 
Symptoms: flu-like illness with rhinitis;
Signs: leucocytosis; normal chest x-ray;
Onset after exposure; 1-6 hours;
Heavy exposure to: dusts of cotton, flax, soft hemp, or kapok;
Resolution: few hours to few days;
Comments: A common etiology is suspected for mill fever and byssinosis: plant dusts contaminated with gram-negative endotoxins. 

Pontiac fever

 
Symptoms: flu-like illness;
Signs: leucocytosis is common; normal chest x-ray;
Onset after exposure: 5 hours to less than 3 days;
Heavy exposure to: bioaerosols containing the bacterium, Legionella pneumophila;
Resolution: one to five days;
Comments: Legionnaires' disease is also caused by Legionella pneumophila. In contrast to Legionnaires' disease, the attack rate for Pontiac fever is high (95-100%), the incubation period is short (5 to 66 hours), and the illness is benign and self-limited (resolution in 1 to 5 days).

References: "Inhalation Fever" by Paul David Blanc in Rom

"Inhalation Fever" by Anna Rask-Andersen in Harber.

Revised: June 27, 2007

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