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.
However, a common regimen beginning at 0.5 mg/kg per day for a couple of days before tapering to a smaller dose for several months to a year, has been used successfully.Corticosteroids effectively reduce inflammation by switching off several genes activated during an inflammatory reaction. The production of anti-inflammatory proteins, and the degeneration of mRNA encoding inflammatory proteins, can also be increased by a high concentration of corticosteroids. These responses can help mitigate the inflammation seen in pneumonitis and reduce symptoms.Certain immune-modulating treatments may be appropriate for patients with chronic pneumonitis. Azathioprine and mycophenolate are two particular treatments that have been associated with an improvement of gas exchange. Patients with chronic pneumonitis also may be evaluated for lung transplantation. Images
See also
Hypersensitivity pneumonitis, also known as extrinsic allergic alveolitis (EAA)
Acute Interstitial Pneumonitis
Radiation Pneumonitis
Chemical Pneumonitis

References


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