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Check That Chest Scan For Saxophone Lung

November 11, 2013
Written by: , Filed in: Chest Radiology, Diagnostic Imaging
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A chest X-ray showed blockages and even a calcified lymph node. Symptoms included coughing and wheezing that lasted a year, with inhalers, steroids, and antibiotics not helping. The eventual diagnosis: saxophone lung.

A presentation Friday at the American College of Allergy, Asthma and Immunology’s (ACAAI) Annual Scientific Meeting in Baltimore highlighted this rare, often-misdiagnosed disease. It doesn’t even require a saxophone; the presentation focused on a clarinetist.

The patient, a 68-year-old Atlanta man, baffled doctors who first thought he had a fungal reaction called allergic bronchopulmonary aspergillosis. Finally, he happened to mention that in addition to his day job, he played clarinet in a Dixieland jazz band. Marissa Shams, MD, who discussed the case during the ACAAI meeting, told NBC News:

He was playing very frequently, several nights a week. Basically, he was kind of breathing in this fungus.

Dr. Shams works at the Emory Healthcare allergy clinic in Atlanta. It turned out that the patient hadn’t cleaned his clarinet in 30 years, inadvertently turning it into a fungus farm. After he finally sterilized it, he began improving.

This is not the first time that saxophone lung has drawn scientific scrutiny. The September 2010 issue of Chest reported on the case of a 48-year-old office clerk who played the saxophone as a hobby. “A CT scan demonstrated the presence of bilateral poorly defined micronodules and ground-glass patchy infiltrates that produced a mosaic pattern,” the report said.

The diagnosis was hypersensitivity pneumonitis caused by inhalation of two types of fungus from the sax. The report concluded: “Musicians may be a population at risk for immunologically induced lung disease. Physicians should be aware of this potential disease in subjects who play a wind instrument.”

Your faithful correspondent took a personal interest in this subject. I own five saxophones (in different sizes). Unfortunately for me but perhaps fortunately for my health, I haven’t had time to play in a couple of years. Before I again pick up one of my horns, I’ll do some sterilizing.

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