Case History: Part Time Farm Worker with Organic Lung Disease

A Pee Dee area family physician consulted with Dr. Schuman regarding a 59 year old man with organic lung disease. The patient had been hospitalized with severe bronchitis and fever for the past two days. He improved rapidly following symptomatic treatment. The patient has no prior history of allergy or asthma and is a non-smoker.

The patient has been working about four hours a day for the past six months at a hog farm. His duties include cleaning the indoor confinement facilities. Since he started working on the hog farm, he has had two other episodes of bronchitis and fever. These developed within a few hours after cleaning the indoor facilities, but resolved after resting overnight. The latest episode was more severe than the previous two and he sought medical attention when his breathing became labored.

This case is typical of organic dust toxic syndrome (ODTS). ODTS is usually a self-limited illness with acute onset of flu-like symptoms after exposure to concentrations of organic dust.1

A gram-negative bacterial endotoxin is common to most exposures. Treatment of ODTS is symptomatic and it is prevented by reducing exposure to organic dust. The patient was advised to use respiratory protection, but he chose to end his employment.

1Schuman SH and Simpson WM. AGMED, The rural practitioners guide to agromedicine. American Academy of Family Physicians, 1997, p. 72.

MUSC DEPARTTMENTT OFF FAMIILLY MEDIICIINE – DIIVIISIION OFF PUBLLIIC HEALLTTH AND PUBLLIIC SERVIICE 19 HAGOOD AVENUE – SUIITTE 305 HOT,, P..O.. BOX 250805,,CHARLLESTTON,, SC 29425