Gardeners warned after man's deathHe inhaled fungal spores from rotting plants

14 June 2008

A potentially lethal biohazard could be lurking at the bottom of the garden, it has been revealed.

Doctors issued the warning following the death of a man who inhaled fungal spores from rotting plant material.

The victim, a previously healthy 47-year-old welder from Buckinghamshire, was admitted to hospital after a week of symptoms including chest pain, shortness of breath, and a sputum-producing cough.

The man had a fever, and at first was assumed to have developed pneumonia from a bacterial infection.

Antibiotics

But a battery of antibiotics failed to improve his condition, doctors reported in The Lancet medical journal.

Within 24 hours he became so short of breath, despite being given oxygen, that he had to be transferred to intensive care.

Tests showed that even with treatment, the man's body tissues were being starved of oxygen. He had signs of 'overwhelming sepsis', a life-threatening response caused by the immune system going into overdrive, a fast heart rate, low blood pressure, and kidney problems.

The patient was referred to a specialist regional centre and placed on a heart-lung machine. But his condition continued to worsen, and he developed kidney failure. Soon afterwards, the man died.

Aspergillus fumigatus

Doctors focused on his gardening activities after the common fungus Aspergillus fumigatus was grown from two sputum samples.

They discovered his symptoms had started less than 24 hours after he had been engulfed by 'clouds of dust' while dispersing rotting tree and plant mulch in his garden.

Blood samples revealed evidence of aspergillosis, a potentially dangerous reaction to Aspergillus spores.

The fungus is commonly found growing on dead leaves, stored grain, compost piles or decaying vegetation.

Allergic reaction

Its spores may trigger a relatively harmless allergic reaction, or a much more serious destructive infection that begins in the lungs and spreads to other parts of the body.

In this case, the patient suffered the deadly invasive form of aspergillosis, which usually strikes people with weak immune systems.

The doctors, led by Dr David Waghorn from Wycombe Hospital in Buckinghamshire, wrote: 'Unlike most patients with acute, invasive aspergillosis, our patient did not seem to be immunosuppressed; however, smoking and welding could have damaged his lungs, increasing his vulnerability.

'Since he died so quickly, we cannot exclude the possibility that he had an undetected immunodeficiency.'

They concluded: 'Acute aspergillosis after contact with decayed plant matter is rare, but may be considered an occupational hazard for gardeners.'

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