Death by bagpipes

Not the irritating, droning, invasive noise that they produce. No, the microbiological, mycological nastiness that lurks inside them if you don’t clean your instrument often enough.

This paper from Thorax – which is “one of the world’s leading respiratory medicine journals, publishing clinical and experimental research articles on respiratory medicine, paediatrics, immunology, pharmacology, pathology, and surgery, and the official journal of the British Thoracic Society” – fills us in on all the details.

The subject was a 61-year old man who exhibited signs of Hypersensitivity* Pneumonitis (HP) – a sort of allergic reaction to “something”, which damages the lungs and causes difficulty with breathing. Keeping birds can be the trigger for HP – it’s called “Pigeon Fancier’s Lung”, and it is relatively common amongst, well, pigeon fanciers. But upon investigation, our 61-year-old didn’t fancy pigeons.

Fungi can also be implicated as the “something” which sets HP off, but they checked his house out and there was no mould or water damage. There must be some other trigger…

This case highlights the importance of a careful clinical history including hobbies, because in this case, playing the bagpipes, we feel, was very relevant to the development of HP.

Yeah. Look, the title of the post had kinda given the game away anyway.

But yes:

The clinical history of daily bagpipe-playing coupled with marked symptomatic improvement when this exposure was removed and the identification of multiple potential precipitating antigens isolated from the bagpipes make this the likely cause.

And boy, oh boy, did they identify multiple potential precipitating antigens from the bagpipes, including (but not limited to) Paecilomyces variotti, Fusarium oxysporum, Penicillium species, Rhodotorula mucilaginosa, Trichosporon mucoides, pink yeast and Exophiala dermatitidis.

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So, if you play the bagpipes, for the love of god, please stop. But if you must continue, then at least clean your instrument regularly. And that goes for any other instrument you put in your mouth as well.
Stop sniggering at the back.

Wind instrument players need to be aware of the importance of regularly cleaning their instruments and of potential risks. Physicians should be aware of this potential risk factor and promote wind instrument hygiene.

So then, bagpipes – now added to the list of things which are trying to (and succeeding in) killing you.

* “hypersensitivity” here referring to an overzealous immune reaction, not people seeking attention and validation by “getting offended” over nothing on twitter.

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