The Case of the Deadly Bagpipes

Take a moment and assess your hobbies. Unless your idea of a good time is bungee jumping or scaling Mt. Everest, your favorite pastimes are likely pretty safe … right? Think again. Experts are calling upon doctors to consider the risks posed by patients’ hobbies after a British man died of a lung infection likely caused by his daily sessions on the bagpipe. They reported their findings in the journal Thorax.

The 61-year-old man had had a persistent cough and trouble breathing for seven years by the time he was referred to a lung disease clinic in the UK in April 2014. Previous doctors had diagnosed the man with hypersensitivity pneumonitis, or HP, an inflammation of the respiratory tract caused by exposure to some sort of pathogen. The man didn’t smoke, own birds (a common trigger), nor did his house show any signs of mold or water damage, yet his symptoms were getting progressively worse. He found a brief respite during a 3-month trip to Australia, during which he reported feeling well enough to take long walks on the beach. But almost immediately after the man returned, his symptoms did, too.

Five months after his initial visit to the clinic, the man’s condition had deteriorated. He was admitted to the hospital, where scans of his chest confirmed a diagnosis of HP. He was given a cocktail of antibiotics and antifungal medications, but the treatment came too late. The man continued to deteriorate and died in early October.

After his arrival in the hospital, doctors began to investigate other possible triggers for his illness. When asked about his hobbies, the patient said he played the bagpipes every single day—with the exception of his sojourn in Australia, when he left the instrument at home.

Researchers took samples from three sites in the bagpipes: within the bag itself (by squeezing the air into a chamber), in its neck, and in its reed protector. Here’s what they found:

Image Credit: King et al. 2016.Thorax.

The unfortunate bagpiper had been sucking in fungus and mold with every inhalation. The physicians can’t say definitively that the bagpipe pathogens caused the man’s death, but they think it’s pretty likely, especially since other doctors have noted cases of HP in trombone and saxophone players.

“This case highlights the importance of a careful clinical history including hobbies,” the authors write. “Clinicians need to be aware of this potential trigger for developing HP, and wind instrument players need to be aware of the importance of regularly cleaning their instruments to minimize this risk.”

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