When Is a Lung Abscess Like Popcorn?

When Is a Lung Abscess Like Popcorn?” asks Dr. Mark Crislip, in a Medscape Today report on December 29, 2010. (Thanks to investigator Edwin Spector for bringing this to our attention.) Dr. Crislip, musing about an odor associated with a particular patient, muses:

The patient is a 17-year-old girl who had been sick for 1 week prior to admission to the hospital….Three days later she observed that her skin was yellow, her urine was orange, and she had developed progressive shortness of breath with a productive cough….

I postulate that this patient’s pneumonia was caused by her saxophone playing. While playing, she uses circular breathing, which allows the epiglottis to remain open.

“Circular breathing is a technique used by players of some wind instruments to produce a continuous tone without interruption.” This is accomplished by breathing in through the nose while simultaneously blowing out through the mouth using air stored in the cheeks.”

The circular breathing could allow aspiration of oral flora. Pulmonary trauma has been described from prolonged saxophone playing, and this could serve as fertile soil for bacterial growth.[3] Saxophones fill up with saliva, which can be emptied requiring a spit valve for occasional emptying, and tilting the saxophone up during the “funky refrain” could facilitate backwash of the stored salvia into the lungs, even though the patient cannot remember a specific aspiration event. Molds have been isolated from saxophones; no one has yet done bacterial cultures.

Finally, saxophone players have a shortened life expectancy compared with other musicians….

next time you have that microwave popcorn and a bottle of chardonnay, remember that the buttery richness is also is the odor of streptococcal abscesses.

Improbable Research