Any particles that are smaller than 5 microns can enter the alveoli of the lungs. These tiny air sacs facilitate the passage of oxygen from inhaled air to the bloodstream. In the case of pneumonitis, it is more difficult for this exchange of oxygen to occur since irritants have caused inflammation of the alveoli. Due to the lack of a definitive determination of a single irritant causing pneumonitis, there are several possible causes. Viral infection. Measles can cause severe pneumonitis, and ribavirin has been proposed as a possible treatment. CMV is another cause. Pneumonia
Radiation therapy
Inhaling chemicals, such as sodium hydroxide
Interstitial lung disease
Sepsis
Adverse reaction to medications
Hypersensitivity to inhaled agents
Inhalation of spores of some species of mushroom (bronchoalveolar allergic syndrome)
Mercury exposure
Smoking
Overexposure to chlorine
Bronchial obstruction (obstructive pneumonitis or post-obstructive pneumonitis)
Ascariasis (during parasite migration)
Aspirin overdose, some antibiotics, and chemotherapy drugs
“Farmer’s lung” and “hot tub lung” are common names for types of hypersensitivity pneumonitis that result from exposure to some types of thermophilic actinomyces, mycobacteria and molds. Avian proteins in bird feces and feathers 
Whole body or chest radiation therapy used for cancer treatment

Symptoms
Physical manifestations of Pneumonitis range from mild cold-like symptoms to respiratory failure. Most frequently, those with pneumonitis experience shortness of breath, and sometimes a dry cough.
Symptoms usually appear a few hours after exposure and peak at approximately eighteen to twenty-four hours.Other symptoms may include:

Malaise
Fever
Dyspnea
Flushed and/or discolored skin
Sweating
Small and fast inhalationsWithout proper treatment, pneumonitis may become chronic pneumonitis, resulting in fibrosis of the lungs and its effects:

Difficulty breathing
Food aversion
LethargyEnd-stage fibrosis and respiratory failure eventually lead to death in cases without proper management of chronic pneumonitis. Diagnosis
A chest X-ray or CT is necessary to differentiate between pneumonitis and pneumonia of an infectious etiology. Some degree of pulmonary fibrosis may be evident in a CT which is indicative of chronic pulmonary inflammatory processes. Diagnosis of Pneumonitis is often difficult as it depends on a high degree of clinical suspicion when evaluating a patient with a recent onset of a possible interstitial lung disease. In addition, interpreting pathologic and radiographic test results remains a challenge to clinicians. Pneumonitis is often difficult to recognize and discern from other interstitial lung diseases.Diagnostic procedures currently available include:

Evaluation of patient history and possible exposure to a known causative agent
High-Resolution Computed Tomography (HRCT) consistent with pneumonitis
Bronchoalveolar lavage with lymphocytosis
Lung biopsy consistent with pneumonitis histopathologyExposure to causative agents of pneumonitis in a specific environment can be confirmed through aero/microbiologic analysis to verify its presence. Subsequent testing of patient serum for evidence of serum specific IgG antibodies confirms patient exposure.Clinical tests include chest radiography or (HRCT) which may show centrilobular nodular and ground-glass opacities with air-trapping in the middle and upper lobes of the lungs. Fibrosis may also be evident.