char = [;code = 91 char = C;code = 67 char = h;code = 104 char = r;code = 114 char = o;code = 111 char = n;code = 110 char = i;code = 105 char = c;code = 99 char = ;code = 32 char = h;code = 104 char = y;code = 121 char = p;code = 112 char = e;code = 101 char = r;code = 114 char = s;code = 115 char = e;code = 101 char = n;code = 110 char = s;code = 115 char = i;code = 105 char = t;code = 116 char = i;code = 105 char = v;code = 118 char = i;code = 105 char = t;code = 116 char = y;code = 121 char = ;code = 32 char = p;code = 112 char = n;code = 110 char = e;code = 101 char = u;code = 117 char = m;code = 109 char = o;code = 111 char = n;code = 110 char = i;code = 105 char = t;code = 116 char = i;code = 105 char = s;code = 115 char = ;code = 32 char = i;code = 105 char = n;code = 110 char = d;code = 100 char = u;code = 117 char = c;code = 99 char = e;code = 101 char = d;code = 100 char = ;code = 32 char = b;code = 98 char = y;code = 121 char = ;code = 32 char = S;code = 83 char = h;code = 104 char = i;code = 105 char = i;code = 105 char = t;code = 116 char = a;code = 97 char = k;code = 107 char = e;code = 101 char = ;code = 32 char = m;code = 109 char = u;code = 117 char = s;code = 115 char = h;code = 104 char = r;code = 114 char = o;code = 111 char = o;code = 111 char = m;code = 109 char = ;code = 32 char = c;code = 99 char = u;code = 117 char = l;code = 108 char = t;code = 116 char = i;code = 105 char = v;code = 118 char = a;code = 97 char = t;code = 116 char = i;code = 105 char = o;code = 111 char = n;code = 110 char = :;code = 58 char = ;code = 32 char = c;code = 99 char = a;code = 97 char = s;code = 115 char = e;code = 101 char = ;code = 32 char = r;code = 114 char = e;code = 101 char = p;code = 112 char = o;code = 111 char = r;code = 114 char = t;code = 116 char = ;code = 32 char = a;code = 97 char = n;code = 110 char = d;code = 100 char = ;code = 32 char = r;code = 114 char = e;code = 101 char = v;code = 118 char = i;code = 105 char = e;code = 101 char = w;code = 119 char = ;code = 32 char = o;code = 111 char = f;code = 102 char = ;code = 32 char = l;code = 108 char = i;code = 105 char = t;code = 116 char = e;code = 101 char = r;code = 114 char = a;code = 97 char = t;code = 116 char = u;code = 117 char = r;code = 114 char = e;code = 101 char = ];code = 93 char = .;code = 46 result sql = [Chronic hypersensitivity pneumonitis induced by Shiitake mushroom cultivation: case report and review of literature].
[Chronic hypersensitivity pneumonitis induced by Shiitake mushroom cultivation: case report and review of literature].char = A;code = 65 char = ;code = 32 char = 7;code = 55 char = 2;code = 50 char = -;code = 45 char = y;code = 121 char = e;code = 101 char = a;code = 97 char = r;code = 114 char = -;code = 45 char = o;code = 111 char = l;code = 108 char = d;code = 100 char = ;code = 32 char = m;code = 109 char = a;code = 97 char = n;code = 110 char = ,;code = 44 char = ;code = 32 char = a;code = 97 char = ;code = 32 char = S;code = 83 char = h;code = 104 char = i;code = 105 char = i;code = 105 char = t;code = 116 char = a;code = 97 char = k;code = 107 char = e;code = 101 char = ;code = 32 char = m;code = 109 char = u;code = 117 char = s;code = 115 char = h;code = 104 char = r;code = 114 char = o;code = 111 char = o;code = 111 char = m;code = 109 char = ;code = 32 char = g;code = 103 char = r;code = 114 char = o;code = 111 char = w;code = 119 char = e;code = 101 char = r;code = 114 char = ;code = 32 char = o;code = 111 char = v;code = 118 char = e;code = 101 char = r;code = 114 char = ;code = 32 char = f;code = 102 char = i;code = 105 char = f;code = 102 char = t;code = 116 char = y;code = 121 char = ;code = 32 char = y;code = 121 char = e;code = 101 char = a;code = 97 char = r;code = 114 char = s;code = 115 char = ,;code = 44 char = ;code = 32 char = w;code = 119 char = a;code = 97 char = s;code = 115 char = ;code = 32 char = a;code = 97 char = d;code = 100 char = m;code = 109 char = i;code = 105 char = t;code = 116 char = t;code = 116 char = e;code = 101 char = d;code = 100 char = ;code = 32 char = t;code = 116 char = o;code = 111 char = ;code = 32 char = o;code = 111 char = u;code = 117 char = r;code = 114 char = ;code = 32 char = h;code = 104 char = o;code = 111 char = s;code = 115 char = p;code = 112 char = i;code = 105 char = t;code = 116 char = a;code = 97 char = l;code = 108 char = ;code = 32 char = b;code = 98 char = e;code = 101 char = c;code = 99 char = a;code = 97 char = u;code = 117 char = s;code = 115 char = e;code = 101 char = ;code = 32 char = o;code = 111 char = f;code = 102 char = ;code = 32 char = b;code = 98 char = i;code = 105 char = l;code = 108 char = a;code = 97 char = t;code = 116 char = e;code = 101 char = r;code = 114 char = a;code = 97 char = l;code = 108 char = ;code = 32 char = c;code = 99 char = h;code = 104 char = e;code = 101 char = s;code = 115 char = t;code = 116 char = ;code = 32 char = i;code = 105 char = n;code = 110 char = t;code = 116 char = e;code = 101 char = r;code = 114 char = s;code = 115 char = t;code = 116 char = i;code = 105 char = t;code = 116 char = i;code = 105 char = a;code = 97 char = l;code = 108 char = ;code = 32 char = s;code = 115 char = h;code = 104 char = a;code = 97 char = d;code = 100 char = o;code = 111 char = w;code = 119 char = ;code = 32 char = w;code = 119 char = i;code = 105 char = t;code = 116 char = h;code = 104 char = ;code = 32 char = c;code = 99 char = h;code = 104 char = r;code = 114 char = o;code = 111 char = n;code = 110 char = i;code = 105 char = c;code = 99 char = ;code = 32 char = c;code = 99 char = o;code = 111 char = u;code = 117 char = g;code = 103 char = h;code = 104 char = ;code = 32 char = a;code = 97 char = n;code = 110 char = d;code = 100 char = ;code = 32 char = b;code = 98 char = r;code = 114 char = e;code = 101 char = a;code = 97 char = t;code = 116 char = h;code = 104 char = l;code = 108 char = e;code = 101 char = s;code = 115 char = s;code = 115 char = n;code = 110 char = e;code = 101 char = s;code = 115 char = s;code = 115 char = .;code = 46 char = ;code = 32 char = C;code = 67 char = h;code = 104 char = e;code = 101 char = s;code = 115 char = t;code = 116 char = ;code = 32 char = c;code = 99 char = o;code = 111 char = m;code = 109 char = p;code = 112 char = u;code = 117 char = t;code = 116 char = e;code = 101 char = d;code = 100 char = ;code = 32 char = t;code = 116 char = o;code = 111 char = m;code = 109 char = o;code = 111 char = g;code = 103 char = r;code = 114 char = a;code = 97 char = p;code = 112 char = h;code = 104 char = y;code = 121 char = ;code = 32 char = s;code = 115 char = h;code = 104 char = o;code = 111 char = w;code = 119 char = e;code = 101 char = d;code = 100 char = ;code = 32 char = t;code = 116 char = r;code = 114 char = a;code = 97 char = c;code = 99 char = t;code = 116 char = i;code = 105 char = o;code = 111 char = n;code = 110 char = ;code = 32 char = b;code = 98 char = r;code = 114 char = o;code = 111 char = n;code = 110 char = c;code = 99 char = h;code = 104 char = i;code = 105 char = e;code = 101 char = c;code = 99 char = t;code = 116 char = a;code = 97 char = s;code = 115 char = i;code = 105 char = s;code = 115 char = ,;code = 44 char = ;code = 32 char = s;code = 115 char = u;code = 117 char = b;code = 98 char = p;code = 112 char = l;code = 108 char = e;code = 101 char = u;code = 117 char = r;code = 114 char = a;code = 97 char = l;code = 108 char = ;code = 32 char = m;code = 109 char = i;code = 105 char = c;code = 99 char = r;code = 114 char = o;code = 111 char = -;code = 45 char = c;code = 99 char = y;code = 121 char = s;code = 115 char = t;code = 116 char = i;code = 105 char = c;code = 99 char = ;code = 32 char = c;code = 99 char = h;code = 104 char = a;code = 97 char = n;code = 110 char = g;code = 103 char = e;code = 101 char = s;code = 115 char = ;code = 32 char = a;code = 97 char = n;code = 110 char = d;code = 100 char = ;code = 32 char = p;code = 112 char = a;code = 97 char = r;code = 114 char = t;code = 116 char = i;code = 105 char = a;code = 97 char = l;code = 108 char = ;code = 32 char = g;code = 103 char = r;code = 114 char = o;code = 111 char = u;code = 117 char = n;code = 110 char = d;code = 100 char = -;code = 45 char = g;code = 103 char = l;code = 108 char = a;code = 97 char = s;code = 115 char = s;code = 115 char = ;code = 32 char = o;code = 111 char = p;code = 112 char = a;code = 97 char = c;code = 99 char = i;code = 105 char = t;code = 116 char = i;code = 105 char = e;code = 101 char = s;code = 115 char = ;code = 32 char = i;code = 105 char = n;code = 110 char = ;code = 32 char = b;code = 98 char = o;code = 111 char = t;code = 116 char = h;code = 104 char = ;code = 32 char = l;code = 108 char = u;code = 117 char = n;code = 110 char = g;code = 103 char = s;code = 115 char = ,;code = 44 char = ;code = 32 char = a;code = 97 char = n;code = 110 char = d;code = 100 char = ;code = 32 char = m;code = 109 char = i;code = 105 char = l;code = 108 char = d;code = 100 char = ;code = 32 char = m;code = 109 char = e;code = 101 char = d;code = 100 char = i;code = 105 char = a;code = 97 char = s;code = 115 char = t;code = 116 char = i;code = 105 char = n;code = 110 char = a;code = 97 char = l;code = 108 char = ;code = 32 char = l;code = 108 char = y;code = 121 char = m;code = 109 char = p;code = 112 char = h;code = 104 char = a;code = 97 char = d;code = 100 char = e;code = 101 char = n;code = 110 char = o;code = 111 char = p;code = 112 char = a;code = 97 char = t;code = 116 char = h;code = 104 char = y;code = 121 char = .;code = 46 char = ;code = 32 char = A;code = 65 char = ;code = 32 char = d;code = 100 char = i;code = 105 char = a;code = 97 char = g;code = 103 char = n;code = 110 char = o;code = 111 char = s;code = 115 char = i;code = 105 char = s;code = 115 char = ;code = 32 char = o;code = 111 char = f;code = 102 char = ;code = 32 char = c;code = 99 char = h;code = 104 char = r;code = 114 char = o;code = 111 char = n;code = 110 char = i;code = 105 char = c;code = 99 char = ;code = 32 char = h;code = 104 char = y;code = 121 char = p;code = 112 char = e;code = 101 char = r;code = 114 char = s;code = 115 char = e;code = 101 char = n;code = 110 char = s;code = 115 char = i;code = 105 char = t;code = 116 char = i;code = 105 char = v;code = 118 char = i;code = 105 char = t;code = 116 char = y;code = 121 char = ;code = 32 char = p;code = 112 char = n;code = 110 char = e;code = 101 char = u;code = 117 char = m;code = 109 char = o;code = 111 char = n;code = 110 char = i;code = 105 char = t;code = 116 char = i;code = 105 char = s;code = 115 char = ;code = 32 char = i;code = 105 char = n;code = 110 char = d;code = 100 char = u;code = 117 char = c;code = 99 char = e;code = 101 char = d;code = 100 char = ;code = 32 char = b;code = 98 char = y;code = 121 char = ;code = 32 char = S;code = 83 char = h;code = 104 char = i;code = 105 char = i;code = 105 char = t;code = 116 char = a;code = 97 char = k;code = 107 char = e;code = 101 char = ;code = 32 char = m;code = 109 char = u;code = 117 char = s;code = 115 char = h;code = 104 char = r;code = 114 char = o;code = 111 char = o;code = 111 char = m;code = 109 char = s;code = 115 char = ;code = 32 char = w;code = 119 char = a;code = 97 char = s;code = 115 char = ;code = 32 char = c;code = 99 char = o;code = 111 char = m;code = 109 char = p;code = 112 char = r;code = 114 char = e;code = 101 char = h;code = 104 char = e;code = 101 char = n;code = 110 char = s;code = 115 char = i;code = 105 char = v;code = 118 char = e;code = 101 char = l;code = 108 char = y;code = 121 char = ;code = 32 char = c;code = 99 char = o;code = 111 char = n;code = 110 char = f;code = 102 char = i;code = 105 char = r;code = 114 char = m;code = 109 char = e;code = 101 char = d;code = 100 char = ;code = 32 char = b;code = 98 char = y;code = 121 char = ;code = 32 char = o;code = 111 char = c;code = 99 char = c;code = 99 char = u;code = 117 char = p;code = 112 char = a;code = 97 char = t;code = 116 char = i;code = 105 char = o;code = 111 char = n;code = 110 char = a;code = 97 char = l;code = 108 char = ;code = 32 char = h;code = 104 char = i;code = 105 char = s;code = 115 char = t;code = 116 char = o;code = 111 char = r;code = 114 char = y;code = 121 char = ,;code = 44 char = ;code = 32 char = r;code = 114 char = a;code = 97 char = d;code = 100 char = i;code = 105 char = o;code = 111 char = l;code = 108 char = o;code = 111 char = g;code = 103 char = i;code = 105 char = c;code = 99 char = a;code = 97 char = l;code = 108 char = ;code = 32 char = f;code = 102 char = i;code = 105 char = n;code = 110 char = d;code = 100 char = i;code = 105 char = n;code = 110 char = g;code = 103 char = s;code = 115 char = ,;code = 44 char = ;code = 32 char = a;code = 97 char = n;code = 110 char = d;code = 100 char = ;code = 32 char = p;code = 112 char = o;code = 111 char = s;code = 115 char = i;code = 105 char = t;code = 116 char = i;code = 105 char = v;code = 118 char = e;code = 101 char = ;code = 32 char = f;code = 102 char = i;code = 105 char = n;code = 110 char = d;code = 100 char = i;code = 105 char = n;code = 110 char = g;code = 103 char = s;code = 115 char = ;code = 32 char = o;code = 111 char = f;code = 102 char = ;code = 32 char = a;code = 97 char = n;code = 110 char = ;code = 32 char = i;code = 105 char = n;code = 110 char = c;code = 99 char = i;code = 105 char = d;code = 100 char = e;code = 101 char = n;code = 110 char = t;code = 116 char = a;code = 97 char = l;code = 108 char = ;code = 32 char = e;code = 101 char = n;code = 110 char = v;code = 118 char = i;code = 105 char = r;code = 114 char = o;code = 111 char = n;code = 110 char = m;code = 109 char = e;code = 101 char = n;code = 110 char = t;code = 116 char = a;code = 97 char = l;code = 108 char = ;code = 32 char = p;code = 112 char = r;code = 114 char = o;code = 111 char = v;code = 118 char = o;code = 111 char = c;code = 99 char = a;code = 97 char = t;code = 116 char = i;code = 105 char = o;code = 111 char = n;code = 110 char = ;code = 32 char = t;code = 116 char = e;code = 101 char = s;code = 115 char = t;code = 116 char = ;code = 32 char = a;code = 97 char = n;code = 110 char = d;code = 100 char = ;code = 32 char = l;code = 108 char = y;code = 121 char = m;code = 109 char = p;code = 112 char = h;code = 104 char = o;code = 111 char = c;code = 99 char = y;code = 121 char = t;code = 116 char = e;code = 101 char = ;code = 32 char = s;code = 115 char = t;code = 116 char = i;code = 105 char = m;code = 109 char = u;code = 117 char = l;code = 108 char = a;code = 97 char = t;code = 116 char = i;code = 105 char = o;code = 111 char = n;code = 110 char = ;code = 32 char = t;code = 116 char = e;code = 101 char = s;code = 115 char = t;code = 116 char = ;code = 32 char = f;code = 102 char = o;code = 111 char = r;code = 114 char = ;code = 32 char = S;code = 83 char = h;code = 104 char = i;code = 105 char = i;code = 105 char = t;code = 116 char = a;code = 97 char = k;code = 107 char = e;code = 101 char = ;code = 32 char = m;code = 109 char = u;code = 117 char = s;code = 115 char = h;code = 104 char = r;code = 114 char = o;code = 111 char = o;code = 111 char = m;code = 109 char = ;code = 32 char = e;code = 101 char = x;code = 120 char = t;code = 116 char = r;code = 114 char = a;code = 97 char = c;code = 99 char = t;code = 116 char = s;code = 115 char = .;code = 46 char = ;code = 32 char = W;code = 87 char = e;code = 101 char = ;code = 32 char = r;code = 114 char = e;code = 101 char = v;code = 118 char = i;code = 105 char = e;code = 101 char = w;code = 119 char = e;code = 101 char = d;code = 100 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = e;code = 101 char = ;code = 32 char = c;code = 99 char = l;code = 108 char = i;code = 105 char = n;code = 110 char = i;code = 105 char = c;code = 99 char = a;code = 97 char = l;code = 108 char = ;code = 32 char = f;code = 102 char = e;code = 101 char = a;code = 97 char = t;code = 116 char = u;code = 117 char = r;code = 114 char = e;code = 101 char = s;code = 115 char = ;code = 32 char = i;code = 105 char = n;code = 110 char = ;code = 32 char = f;code = 102 char = i;code = 105 char = v;code = 118 char = e;code = 101 char = ;code = 32 char = p;code = 112 char = a;code = 97 char = t;code = 116 char = i;code = 105 char = e;code = 101 char = n;code = 110 char = t;code = 116 char = s;code = 115 char = ;code = 32 char = w;code = 119 char = i;code = 105 char = t;code = 116 char = h;code = 104 char = ;code = 32 char = c;code = 99 char = h;code = 104 char = r;code = 114 char = o;code = 111 char = n;code = 110 char = i;code = 105 char = c;code = 99 char = ;code = 32 char = h;code = 104 char = y;code = 121 char = p;code = 112 char = e;code = 101 char = r;code = 114 char = s;code = 115 char = e;code = 101 char = n;code = 110 char = s;code = 115 char = i;code = 105 char = t;code = 116 char = i;code = 105 char = v;code = 118 char = i;code = 105 char = t;code = 116 char = y;code = 121 char = ;code = 32 char = p;code = 112 char = n;code = 110 char = e;code = 101 char = u;code = 117 char = m;code = 109 char = o;code = 111 char = n;code = 110 char = i;code = 105 char = t;code = 116 char = i;code = 105 char = s;code = 115 char = ;code = 32 char = i;code = 105 char = n;code = 110 char = d;code = 100 char = u;code = 117 char = c;code = 99 char = e;code = 101 char = d;code = 100 char = ;code = 32 char = b;code = 98 char = y;code = 121 char = ;code = 32 char = S;code = 83 char = h;code = 104 char = i;code = 105 char = i;code = 105 char = t;code = 116 char = a;code = 97 char = k;code = 107 char = e;code = 101 char = ;code = 32 char = m;code = 109 char = u;code = 117 char = s;code = 115 char = h;code = 104 char = r;code = 114 char = o;code = 111 char = o;code = 111 char = m;code = 109 char = s;code = 115 char = ;code = 32 char = r;code = 114 char = e;code = 101 char = p;code = 112 char = o;code = 111 char = r;code = 114 char = t;code = 116 char = e;code = 101 char = d;code = 100 char = ;code = 32 char = i;code = 105 char = n;code = 110 char = ;code = 32 char = J;code = 74 char = a;code = 97 char = p;code = 112 char = a;code = 97 char = n;code = 110 char = .;code = 46 char = ;code = 32 char = T;code = 84 char = h;code = 104 char = e;code = 101 char = r;code = 114 char = e;code = 101 char = ;code = 32 char = w;code = 119 char = a;code = 97 char = s;code = 115 char = ;code = 32 char = a;code = 97 char = ;code = 32 char = t;code = 116 char = e;code = 101 char = n;code = 110 char = d;code = 100 char = e;code = 101 char = n;code = 110 char = c;code = 99 char = y;code = 121 char = ;code = 32 char = t;code = 116 char = o;code = 111 char = w;code = 119 char = a;code = 97 char = r;code = 114 char = d;code = 100 char = ;code = 32 char = i;code = 105 char = n;code = 110 char = c;code = 99 char = r;code = 114 char = e;code = 101 char = a;code = 97 char = s;code = 115 char = i;code = 105 char = n;code = 110 char = g;code = 103 char = ;code = 32 char = l;code = 108 char = y;code = 121 char = m;code = 109 char = p;code = 112 char = h;code = 104 char = o;code = 111 char = c;code = 99 char = y;code = 121 char = t;code = 116 char = e;code = 101 char = s;code = 115 char = ;code = 32 char = a;code = 97 char = n;code = 110 char = d;code = 100 char = ;code = 32 char = h;code = 104 char = i;code = 105 char = g;code = 103 char = h;code = 104 char = ;code = 32 char = C;code = 67 char = D;code = 68 char = 4;code = 52 char = /;code = 47 char = C;code = 67 char = D;code = 68 char = 8;code = 56 char = ;code = 32 char = r;code = 114 char = a;code = 97 char = t;code = 116 char = i;code = 105 char = o;code = 111 char = ;code = 32 char = i;code = 105 char = n;code = 110 char = ;code = 32 char = b;code = 98 char = r;code = 114 char = o;code = 111 char = n;code = 110 char = c;code = 99 char = h;code = 104 char = o;code = 111 char = a;code = 97 char = l;code = 108 char = v;code = 118 char = e;code = 101 char = o;code = 111 char = l;code = 108 char = a;code = 97 char = r;code = 114 char = ;code = 32 char = l;code = 108 char = a;code = 97 char = v;code = 118 char = a;code = 97 char = g;code = 103 char = e;code = 101 char = ;code = 32 char = f;code = 102 char = l;code = 108 char = u;code = 117 char = i;code = 105 char = d;code = 100 char = s;code = 115 char = .;code = 46 char = ;code = 32 char = T;code = 84 char = r;code = 114 char = e;code = 101 char = a;code = 97 char = t;code = 116 char = m;code = 109 char = e;code = 101 char = n;code = 110 char = t;code = 116 char = ;code = 32 char = w;code = 119 char = i;code = 105 char = t;code = 116 char = h;code = 104 char = ;code = 32 char = s;code = 115 char = t;code = 116 char = e;code = 101 char = r;code = 114 char = o;code = 111 char = i;code = 105 char = d;code = 100 char = s;code = 115 char = ;code = 32 char = s;code = 115 char = e;code = 101 char = e;code = 101 char = m;code = 109 char = s;code = 115 char = ;code = 32 char = t;code = 116 char = o;code = 111 char = ;code = 32 char = h;code = 104 char = a;code = 97 char = v;code = 118 char = e;code = 101 char = ;code = 32 char = a;code = 97 char = ;code = 32 char = l;code = 108 char = i;code = 105 char = m;code = 109 char = i;code = 105 char = t;code = 116 char = e;code = 101 char = d;code = 100 char = ;code = 32 char = e;code = 101 char = f;code = 102 char = f;code = 102 char = e;code = 101 char = c;code = 99 char = t;code = 116 char = ,;code = 44 char = ;code = 32 char = w;code = 119 char = h;code = 104 char = i;code = 105 char = l;code = 108 char = e;code = 101 char = ;code = 32 char = a;code = 97 char = v;code = 118 char = o;code = 111 char = i;code = 105 char = d;code = 100 char = a;code = 97 char = n;code = 110 char = c;code = 99 char = e;code = 101 char = ;code = 32 char = o;code = 111 char = f;code = 102 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = e;code = 101 char = ;code = 32 char = a;code = 97 char = n;code = 110 char = t;code = 116 char = i;code = 105 char = g;code = 103 char = e;code = 101 char = n;code = 110 char = ;code = 32 char = i;code = 105 char = s;code = 115 char = ;code = 32 char = i;code = 105 char = m;code = 109 char = p;code = 112 char = o;code = 111 char = r;code = 114 char = t;code = 116 char = a;code = 97 char = n;code = 110 char = t;code = 116 char = .;code = 46 char = <;code = 60 char = b;code = 98 char = r;code = 114 char = /;code = 47 char = >;code = 62 result sql = A 72-year-old man, a Shiitake mushroom grower over fifty years, was admitted to our hospital because of bilateral chest interstitial shadow with chronic cough and breathlessness. Chest computed tomography showed traction bronchiectasis, subpleural micro-cystic changes and partial ground-glass opacities in both lungs, and mild mediastinal lymphadenopathy. A diagnosis of chronic hypersensitivity pneumonitis induced by Shiitake mushrooms was comprehensively confirmed by occupational history, radiological findings, and positive findings of an incidental environmental provocation test and lymphocyte stimulation test for Shiitake mushroom extracts. We reviewed the clinical features in five patients with chronic hypersensitivity pneumonitis induced by Shiitake mushrooms reported in Japan. There was a tendency toward increasing lymphocytes and high CD4/CD8 ratio in bronchoalveolar lavage fluids. Treatment with steroids seems to have a limited effect, while avoidance of the antigen is important.
Publication: Nihon Kokyuki Gakkai Zasshi 2008 May ;46(5)::411-5.
Publication Date: 2008 May
Study Author(s): Kai, Naoko;Ishii, Hiroshi;Iwata, Atsuko;Umeki, Kenji;Shirai, Ryo;Morinaga, Ryotaro;Kishi, Kenji;Tokimatsu, Issei;Hiramatsu, Kazufumi;Yamagata, Eiji;Kadota, Jun-Ichi;
Institution: Department of Infectious Diseases, Oita University Faculty of Medicine.
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A 72-year-old man, a Shiitake mushroom grower over fifty years, was admitted to our hospital because of bilateral chest interstitial shadow with chronic cough and breathlessness. Chest computed tomography showed traction bronchiectasis, subpleural micro-cystic changes and partial ground-glass opacities in both lungs, and mild mediastinal lymphadenopathy. A diagnosis of chronic hypersensitivity pneumonitis induced by Shiitake mushrooms was comprehensively confirmed by occupational history, radiological findings, and positive findings of an incidental environmental provocation test and lymphocyte stimulation test for Shiitake mushroom extracts. We reviewed the clinical features in five patients with chronic hypersensitivity pneumonitis induced by Shiitake mushrooms reported in Japan. There was a tendency toward increasing lymphocytes and high CD4/CD8 ratio in bronchoalveolar lavage fluids. Treatment with steroids seems to have a limited effect, while avoidance of the antigen is important.
PMID: 18517019