Wind musicians have been warned to clean their instruments to avoid developing ‘bagpipe lung’
Having lived in Scotland for the past 7 years and always had a soft spot for the bagpipes (much to my mother's disdain!), a recent news item caught my eye.
In a microbiological ‘whodunnit’, a recent article in Thorax by Jenny King and colleagues has described a case of hypersensitivity pneumonitis, which the authors believe was triggered by the regularly playing of the bagpipes. Sampling of the patient’s bagpipes revealed a number of fungi lurking in the various components of the instrument. Many of these fungi, including Paecilomyces variotti, Fusarium oxysporum, Penicillium species, Rhodotorula mucilaginosa, Trichosporon mucoides, pink yeast and Exophiala dermatitidis, have been previously implicated with the development of hypersensitivity pneumonitis, and the “moist” environment within bagpipes makes an ideal breeding ground for these nasty little critters. This is not the first time musicians have succumbed to hypersensitivity pneumonitis – it has also been reported in a saxophone and trombone player.
Curiously, the trigger of hypersensitivity pneumonitis is often not identified, and no moulds or fungi were isolated from the patient during a post-mortem examination, so the development of this condition still harbours many unanswered questions. For the bagpipe player, the musical trigger was not realised until it was perhaps too late: symptoms eased when the patient periodically stopped playing the bagpipes, but the cause of death was determined to be “an acute exacerbation of interstitial lung disease” – characteristic of a chronic hypersensitivity pneumonitis history.
The authors of this study have urged the full compilation of a patient’s history including hobbies to provide the best picture for diagnosis of triggers, and for musicians to regularly clean their instruments with alcohol to minimise contamination and disease triggers. Sound advice – clean yer ‘pipes, folks!