Was case of ‘Bird Lung’ an allergy or infection?

DEAR DR. ROACH: I was a very active, healthy, young 68-year-old until March, when I was hospitalized for two weeks for bilateral pneumonia. I was told by the doctors at the hospital that it would take four to six weeks to get my health back. However, I experienced shortness of breath and bouts of coughing for months, and insisted on seeing a specialist three weeks ago. A CT scan and bronchoscopy showed symptoms typical of bird lung. We had a cockatiel for 17 years!

I am now taking prednisone and ibuprofen, which are helping to clear up the inflammation. I hope to be able to return to work soon. My family doctor and several other doctors I know said that they’d studied this at med school but had never seen a case in their practices. I hope this serves as a warning to other people who might be tempted to buy a pet bird or to breed them. I was lucky, but someone in poor health might not have survived the deadly combination of pneumonia and bird lung.

ANSWER: “Bird lung” is a term that might refer to either of two possibilities. The first condition is “bird-fanciers lung” — essentially an allergic reaction to bird droppings, feathers and the proteins of various birds. It can look very much like pneumonia, with abnormal chest X-ray findings that can be indistinguishable. The only cure is to get away from the source of the allergens, but prednisone might be necessary in severe cases. It is not an infection.

The second possibility is an infection called psittacosis (sit-a-CO-sis), caused by the bacterium Chlamydia psittaci. Cockatiels are commonly infected by this organism, and the birds do not always appear ill. Psittacosis can be a very severe illness, potentially affecting multiple systems, but it usually responds rapidly to appropriate antibiotics, such as tetracyclines.

Given your history, I suspect that bird-fancier’s lung, also called hypersensitivity pneumonitis, is more likely. It sounds like your specialist is treating you appropriately.

DEAR DR. ROACH: Bottled and purified water sales have increased over the years. I often see advertisements showing filters attached to faucets that “take out all impurities.” My parents had a water softener, and my father, professionally involved in weight-bearing physical activity, experienced demineralization of his skeleton and a broken hip. It has been suggested that the water softener took minerals, including calcium, out of the water that my parents used to cook and drink.

I drink tap water, but is a large percentage of the U.S. population headed for demineralization and malnutrition because they drink only “purified water”? — C.D.

ANSWER: Most water softeners work by exchanging sodium for the “hard” minerals, especially magnesium and calcium, present in most tap water, to greater or lesser extent. If the water in your area is naturally very hard, then a significant amount of sodium may be added, and calcium and magnesium removed.

However, this is very rarely a problem, and almost certainly had nothing to do with why your father had a hip fracture. We get our minerals mostly from food, not from water. The major risk factors for osteoporosis in men are smoking, alcohol, low testosterone levels and low vitamin D, although there are many other causes.

I don’t recommend bottled water or water purifiers because in most of the United States and Canada, the water quality is excellent. Bottled water is 1,000 times more expensive than tap water where I live. I have been to places where the tap water doesn’t taste so good, in which case I would recommend a filter over bottled water.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at 628 Virginia Dr., Orlando, FL 32803. Health newsletters may be ordered from www.rbmamall.com.