KAOLINOSIS IN A COTTON MILL WORKER

A 62-year-old white male employed for 43 years in the polishing room o f a cotton textile mill was admitted to a tertiary care center with pr ogressive dyspnea and productive cough that had not responded to thera py for tuberculosis. In spite of aggressive antibiotic therapy and res piratory support, the patient died as a consequence of respiratory fai lure. Small rounded and irregular opacities had been noted on the ches t radiograph. Review of job-site spirometry demonstrated a worsening r estrictive pattern over a 4-year period prior to his death. Additional occupational history revealed long-term exposure to kaolin in the pol ishing room, and pathologic examination of lung tissue confirmed exten sive fibrosis and substantial quantities of kaolin. Kaolinosis is a di sease typically found among individuals involved in mining or processi ng this material rather than in user industries. This case illustrates the importance of obtaining a complete occupational history in reachi ng a diagnosis. The clinicopathologic aspects of kaolinosis are also r eviewed. (C) 1996 Wiley-Liss, Inc.