Galland C, Reynaud C, De Haller R, Polla B S, Leuenberger P
Service de Pneumologie, Centre Hospitalier Universitaire Vaudois, Suisse.
Rev Mal Respir. 1991;8(4):381-6.
Inhalation of organic particles (bacteria, fungi or animal proteins) by sensitized subjects is known to induce extrinsic allergic alveolitis (EAA). The most frequent type of EAA and the best known in rural environment is farmer's lung disease. Nevertheless a rarer form is also to be considered in rural environment: cheesewasher's disease. Here we report 4 cases of cheesewasher's disease, who all presented with relevant aspects of the disease: diversity of antigens involved, prophylaxis problems, severity of the disease, rapidity of onset, reversibility and importance of history in the diagnosis. Penicillium casei usually is the responsible antigen, and precipitating antibodies against these moulds, but against other moulds such as Aspergillus, Circinomucor circilloïdes, Fusarium as well, can be detected in the patient's serum. Thus, in a rural environment, a respiratory symptomatology suggestive of EAA should lead to thorough search for antigens and cheesewasher's disease should be considered. Among the many other diagnostic tests, precipitin determinations are cheap and non invasive and can be very useful in the diagnostic approach.
已知致敏个体吸入有机颗粒（细菌、真菌或动物蛋白）会诱发外源性过敏性肺泡炎（EAA）。EAA最常见的类型且在农村环境中最为人所知的是农民肺疾病。然而，在农村环境中也应考虑一种较为罕见的形式：洗干酪工人肺疾病。在此，我们报告4例洗干酪工人肺疾病病例，所有病例均呈现出该疾病的相关特征：涉及抗原的多样性、预防问题、疾病的严重程度、起病速度、可逆性以及病史在诊断中的重要性。干酪青霉通常是致病抗原，患者血清中可检测到针对这些霉菌以及其他霉菌如曲霉菌、环孢毛霉、镰刀菌的沉淀抗体。因此，在农村环境中，提示EAA的呼吸道症状应促使全面寻找抗原，并应考虑洗干酪工人肺疾病。在众多其他诊断测试中，沉淀素测定价格低廉且无创，在诊断方法中可能非常有用。
