Musicians who play wind instruments have been advised to regularly clean them after a 61-year-old man died of a lung disease believed to have been caused by mould inside his bagpipes. Doctors issued a warning for the hazard dubbed "bagpipe lung" after the man died of the chronic inflammatory lung condition, hypersensitivity pneumonitis.
Doctors believe the death of the man in 2014 may have been caused by years of breathing in mould and fungus which was festering inside the moist interior of his bagpipes.
Writing in the journal Thorax, doctors described hypersensitivity pneumonitis as being triggered by the immune system's response to an inhaled environmental antigen, which is usually associated with occupational exposure to birds such as pigeons.
When the 61-year-old was diagnosed with the lung disease in 2009, the cause had not been identified as he was not a pigeon carrier, his home did not show signs of mould or water damage, nor was he a smoker. However, the man did play the bagpipes daily as a hobby and his symptoms "rapidly improved" when he did not play them for three months while on holiday in Australia.
This prompted samples to be taken for testing from several areas inside his bagpipes, including the bag, the neck, and the chanter reed protector. Tests revealed the instrument contained several variations of fungi, including Paecilomyces variotii, Fusarium oxysporum, Penicillium species, Rhodotorula mucilaginosa, Trichosporon mucoides and Exophiala dermatitidis.
Despite being treated with immunosuppressant drugs for seven years, the man's condition worsened to a point that he couldn't walk more than 20 metres because of his breathing difficulties. Following his death, a post mortem examination revealed extensive lung damage consistent with acute respiratory distress syndrome and tissue fibrosis.
While the cause of the man's lung condition was not definitely proved, doctors said there have been similar cases of hypersensitivity pneumonitis occurring in trombone and saxophone players.
Doctors from the University Hospital South Manchester NHS Foundation Trust wrote: "This is the first case report identifying fungal exposure, from a bagpipe player, as a potential trigger for the development of [hypersensitivity pneumonitis].
"The clinical history of daily bagpipe playing, coupled with marked symptomatic improvement when this exposure was removed, and the identification of multiple potential precipitating antigens isolated from the bagpipes, make this the likely cause."
Wind musicians have now been warned against the potential risk of hypersensitivity pneumonitis as their instruments are at risk of being contaminated with mould. "Although there isn't any guidance on the optimal hygiene regimen, cleaning instruments immediately after use and allowing them to drip dry could theoretically curb the risk of microbe growth," doctors suggest.