Acute Crit Care.  2020 May;35(2):122-126. 10.4266/acc.2018.00332.

Lung injury associated with inhalation of effective microorganism blends

Affiliations
  • 1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, National Medical Center, Seoul, Korea
  • 2Departments of Pathology, Seoul National University College of Medicine, Seoul, Korea
  • 3Departments of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
  • 4Department of Pulmonary and Critical Care Medicine, Seoul National University Bundang Hospital, Seongnam, Korea

Abstract

Since 2009, effective microorganisms (EMs) have been supplied by the local government to the citizens of Seongnam, Korea, for various environment-protective uses including manufacturing detergents, cosmetics and humidifier disinfectants. A 68-year-old man who had placed an EM blends into a humidifier for inhalation visited the emergency room with complaints of fever and dyspnea. He was in a shock state with hypoxia. Chest computed tomography revealed diffuse ground-glass opacities that were dominant in the bilateral upper lobes. Fiberoptic bronchoscopy with bronchoalveolar lavage and transbronchial lung biopsy was performed. Bronchoalveolar lavage fluid analysis and biopsy findings were consistent with alveolar hemorrhage. All microbiological and virological test results were negative. His symptoms and radiographic opacities had improved markedly after several days of conservative care, and he was discharged healthy after 1 week of hospital stay.

Keyword

acute lung injury; haemorrhage; inhalation; microorganism fermentation extract

Figure

  • Figure 1. (A) Initial chest X-ray showing dense consolidation in right upper and middle lung field. (B) Chest X-ray on hospital day 6 revealing the resolution of consolidative lesions. (C, D) Chest computed tomography showing upper lobe-dominant consolidation with bilateral ground-glass opacities.

  • Figure 2. Transbronchial lung biopsy of right upper lobe. (A) Many fibrin deposits (asterisk) within alveolar space which is consistent with alveolar hemorrhage (H&E, ×200). Deposition of inflammatory cells (arrows) in interstitium is also noted. (B) Alveoli with capillaries showing that there is no evidence of vasculitis (right; H&E, ×400).


Reference

1. Higa T, Parr JF. Beneficial and effective microorganisms for a sustainable agriculture and environment. Atami: International Nature Farming Research Center;1994.
2. Higa T, Wididana GN. The concept and theories of effective microorganisms. In : Proceedings of the first international conference on Kyusei Nature Farming; Washington, DC. US Department of Agriculture. 1991.
3. Abdel-Shafy HI, AL-Sulaiman AM, Mansour MS. Greywater treatment via hybrid integrated systems for unrestricted reuse in Egypt. J Water Process Eng. 2014; 1:101–7.
Article
4. Szymanski N, Patterson RA. 2003 Effective microorganisms (EM) and wastewater systems in future directions for on-site systems: best management practice. In : Patterson RA, Jones MJ, editors. Proceedings of On-site ’03 Conference; 2003 Sep 30-Oct 2; Armidale, Australia. Armidale: Lanfax Laboratories Armidale;2003. p. 347–54.
5. Paek D, Koh Y, Park DU, Cheong HK, Do KH, Lim CM, et al. Nationwide study of humidifier disinfectant lung injury in South Korea, 1994-2011: incidence and dose-response relationships. Ann Am Thorac Soc. 2015; 12:1813–21.
Article
6. Kim WY, Hong SB. Humidifier disinfectant-associated lung injury: six years after the tragic event. Tuberc Respir Dis (Seoul). 2017; 80:351–7.
Article
7. Do JS, Seo HJ, Hwang JK, Kim JH, Nam SY. Effective microorganism fermentation extract (EM-X) attenuates airway hyperreactivity and inflammation through selective inhibition of the TH2 response independently of antioxidant activity. Int J Mol Med. 2007; 20:631–5.
Article
Full Text Links
  • ACC
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr