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Hálmsótt eða heysótt? : sjúkratilfelli

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Authors
Gunnar Guðmundsson
Lýður Ólafsson
Sigfús Nikulásson
Birna Jónsdóttir
Issue Date
2005-07-01

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Other Titles
Farmer's lung disease caused by straw or hay? Case report
Citation
Læknablaðið 2005, 91(7-8):587-9
Abstract
A young woman was admitted to Akranes Regional Hospital because of dyspnea, fatigue and fever. She was found to have bilateral pneumonia but etiology was not found. She was treated with antibiotics with good resolution and was discharged after eight days from the hospital. Four weeks later she noticed rapidly progressive dyspnea and was found to be hypoxemic, and to have restrictive spirometry and diffuse interstitial changes on chest radiography. Computerized tomography of the lungs showed diffuse ground glass changes. Transbronchial biopsies from the lungs showed numerous small granulomas. She was treated with prednisolone for a short time with excellent recovery. She stall-fed horses and underneath them was straw containing organic dust. This is important to keep in mind as a differential diagnosis to farmers lung disease that is caused by hay.
Ung kona var lögð inn á sjúkrahúsið á Akranesi vegna mæði, slappleika og hita. Hún reyndist vera með lungnabólgu í báðum lungum en ekki tókst að finna orsök. Hún var meðhöndluð með sýkla­lyfjum og batnaði vel og útskrifaðist eftir átta daga legu. Fjórum vikum síðar fann hún fyrir hratt vaxandi mæði og reyndist vera með lágan súrefnisþrýsting í blóði, herpu við blásturspróf og dreifðar breytingar í millivef lungna á röntgenmynd. Tölvusneiðmynd sýndi dreifðar hélubreytingar. Vefjasýni frá lungum leiddi í ljós fjöldamarga litla bólguhnúða (granúlóma). Hún var meðhöndluð með prednisólón í stuttan tíma og batnaði fljótt. Hún var með hesta í húsi og var undir þeim hálmur sem í var lífrænt ryk. Hér er því um að ræða hálmsótt sem er mismunagreining við heysótt sem orðin er sjaldgæf á Íslandi.
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Icelandic Journal Articles (Peer Reviewed)

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