Fatal acute interstitial pneumonia in a worker making chips from wooden debris generated by the Great East Japan earthquake and tsunami

A man was admitted to our hospital with shortness of breath. He was involved in making wood chips from contaminated debris created by the tsunami that occurred after the Great East Japan Earthquake. Fungi detected at his home and workplace were possible inducers of hypersensitivity pneumonitis, but the absence of precipitating antibodies countered this diagnosis. His rapid and progressive clinical course and surgical lung biopsy and bronchoalveolar lavage findings suggested acute interstitial pneumonia. Electron probe X-ray microanalysis revealed the deposition of excessive exogenous substances in bronchiolar regions. Inhalation of harmful materials was suspected to be the cause of acute lung injury.