Hypersensitivity pneumonitis from Pezizia domiciliana - A case of El Nino lung

A previously healthy woman developed severe dyspnea and was found to have r estrictive lung disease and evidence of alveolitis. Open lung biopsy reveal ed extrinsic allergic alveolitis (hypersensitivity pneumonitis). The etiolo gy was not initially apparent, but a home inspection showed an unusual mush room growing in the patient's basement. Air sampling and serum precipitins against the fungal antigens confirmed that Pezizia domiciliana was the caus e of the patient's hypersensitivity pneumonitis. This is the first describe d case of hypersensitivity pneumonitis cause by P, domiciliana. We speculat e that unprecedented rainfall and flooding of the patient's basement as a r esult of El Nino rains produced ideal factors for the growth of this fungus .