Ann Agric Environ Med 1998, 5, 31-43


Janusz Milanowski1,2, Jacek Dutkiewicz2, Hanna Potoczna3, Leszek Kuœ1, Barbara Urbanowicz4

1Clinic of Lung Diseases, Medical Academy, Lublin, Poland
2Department of Aerobiology and Allergology, Institute of Agricultural Medicine, Lublin, Poland
3Department of Lung Diseases, City Hospital, Lublin, Poland
4Laboratory of Electron Microscopy, Institute of Pediatrics, Collegium Medicum, Jagiellonian University, Kraków, Poland

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Milanowski J, Dutkiewicz J, Potoczna H, Kuœ L, Urbanowicz B: Allergic alveolitis among agricultural workers in eastern Poland: a study of twenty cases. Ann Agric Environ Med 1998, 5, 31-43.

Abstract: The aim of this study was to identify the specific agents which caused extrinsic allergic alveolitis (EAA) in the selected group of 20 agricultural workers from eastern Poland. The microbiological analysis of the samples of plant materials or dusts reported by the patients as causing symptoms has been carried out, followed by allergological tests (inhalation challenge, agar-gel precipitation test, inhibition of leukocyte migration, skin test) with extrinsic microbial antigens. It was found that the causative agents of allergic alveolitis in the examined group of patients were mesophilic, non-branching bacteria associated with grain dust, mostly Pantoea agglomerans (synonyms: Erwinia herbicola, Enterobacter agglomerans) and Arthrobacter globiformis (each in eight cases). The remaining agents were Alcaligenes faecalis (in two cases), and Brevibacterium linens and Staphylococcus epidermidis (in one case each). On the basis of the clinical picture, the bronchoalveolar lavage (BAL) and allergological tests, the diagnosis of the chronic form of the disease was stated in 14 patients and an acute form - in 6 patients. EAA patients demonstrated in the BAL fluid a typical lymphocytic alveolitis both in terms of percentage and absolute number of lymphocytes. Also, the numbers of eosinophils and neutrophils were significantly higher in EAA patients.

Address for correspondence: Professor Janusz Milanowski, MD, Clinic of Lung Diseases, Medical Academy, Jaczewskiego 8, 20-090 Lublin, Poland.

Key words:allergic alveolitis, agricultural workers, clinical cases, etiology, organic dusts, Gram-negative bacteria, corynebacteria, staphylococci, inhalation challenge, BAL.