silo-filler disease

silo-filler disease

A toxic gas-induced pneumonitis and bronchiolitis caused by inhalation of nitrogen oxides in freshly filled grain silos, often coupled with asphyxia.
 
Clinical findings
Cough, light headedness, dyspnoea, cyanosis, haemoptysis, choking.
Clinical forms
• Collapse and sudden death;
• Acute alveolar damage with pulmonary oedema;
• Early, reversible bronchiolitis obliterans; and
• Late, irreversible bronchiolitis obliterans.
 
DiffDx
Mycotoxicosis, an allergic reaction.
 
Management
High-dose corticosteroids may prevent the bronchiolitis obliterans common in the heavily exposed survivors.
 
Pathogenesis
Once grains are stored, plant nitrates are fermented by microbes to NO2 and N2O4, peaking 1–5 days after storage; NO2 reaches terminal airways, forming highly irritating nitrous and nitric acids, causing a chemical pneumonitis and massive pulmonary oedema.

silo-filler disease

Silo-filler's lung Occupational medicine A toxic gas-induced pneumonitis and bronchiolitis caused by inhalation of nitrogen oxides in freshly filled grain silos, often coupled to asphyxia Clinical Cough, light headedness, dyspnea, cyanosis, hemoptysis, choking Forms of presentation 1. Collapse and sudden death;.2. Acute alveolar damage with pulmonary edema;.3. Early reversible bronchiolitis obliterans and.4. Late irreversible bronchiolitis obliterans DiffDx Mycotoxicosis, an allergic reaction Treatment High dose corticosteroids may prevent the bronchiolitis obliterans common in the heavily exposed survivors. See 'Animal House' fever, Farmer's lung.