Helpful clues in the recognition of hypersensitivity pneumonitis

History of recurrent atypical pneumonia (eg, fever, cough, shortness of breath), particularly if there is regularity to the illness (eg, only in spring or fall, only certain time of week, in certain place, or following certain events)

Symptoms developed after moving to new job or home

Other people have similar symptoms or have left work because of recurrent symptoms

Patient feels better when away from home or work (such as after a vacation)

Does the patient have exposure to any of the following:

Pets (especially birds); cleaning outside bird feeder

Hobby involving feathers, fur, or plants

Use of feather pillow, duvet, sleeping bag, jacket

Wind instrument player

History of water damage to home or office, particularly to crawl space, basement, roof, ceiling tiles, carpet (even if cleaned)

Use of hot tub, jacuzzi, sauna, swimming pool

Use of air conditioning units, humidifier, air cooler

Workplace exposures* (eg, laboratory animals, veterinary work, barn, horse stable, farming, hay handling, mushroom growing or processing, brewery, winery, metalworking, plastics or epoxy manufacturing, spray painting)

* The list of workplace exposures associated with hypersensitivity pneumonitis is much longer; the settings listed are just a sampling. Refer to UpToDate content on causes of hypersensitivity pneumonitis.

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Helpful clues in the recognition of hypersensitivity pneumonitis