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Extrinsic allergic alveolitis — DOccMed MCQ

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ModerateOccupational Lung DiseaseExtrinsic allergic alveolitisDOccMed

A 36-year-old mushroom farm worker has fever, malaise and breathlessness several hours after cleaning compost tunnels. Spirometry shows a restrictive pattern, oxygen saturation falls on exertion and HRCT shows diffuse ground-glass change. What is the most likely occupational diagnosis?

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Correct answer: D — Extrinsic allergic alveolitis from organic antigen exposure

Extrinsic allergic alveolitis presents with systemic symptoms after antigen exposure, restrictive physiology and interstitial changes. The timing after compost work and HRCT findings are more consistent with alveolitis than asthma. Silicosis requires silica exposure and would not usually present with this acute post-exposure pattern. Viral bronchitis would not explain recurrent exposure-linked episodes with restrictive spirometry.

Reference: HSE Respiratory Sensitisers guidance; Occupational lung disease guidance