Mysterious Death After Gardening

June 13, 2008 — -- When a man in England opened some bags of old gardening mulch last spring, a dense cloud of dust billowed up around him.

The 47-year-old welder did not know that the cloud he and his partner saw wasn't dust but spores of a common fungus. Nor did he know that his day of gardening would lead to his untimely death days later.

Doctors in the local intensive-care unit raced to diagnose him as his lungs slowly shut down. Now, a year after his death, specialists at the local Buckinghamshire Hospital have published their explanation for this unusual case in the journal Lancet.

The doctors say an extremely rare infection — once in a medical career rare — from the aspergillus spore caused his deadly infection. However, top minds in the United States have a different solution to this mystery: from a centuries-old "farmer's lung" reaction to a rare genetic disease diagnosis.

"We only managed to find out what really was going on with him from the story from his partner," says Dr. David Waghorn, of the department of microbiology of Wycombe Hospital, Buckinghamshire, U.K.

"She remembered him being almost enveloped in a whole cloud of dust," Waghorn says. One of the many tests the doctors gave to the gardener was a spit test, and after his death, his spit grew a colony of aspergillus spores.

These spores float around in the air in small amounts, and most people breathe them in with no problem at all, Waghorn says. But some people with weakened immune systems such as leukemia patients, or lung disease patients, can develop a serious infection from them.

Waghorn and his colleagues knew aspergillus spores particularly love to grow in warm, nutrient-rich compost and mulch, and the partner reported the mulch the gardener was using had been sitting around for a long time collecting spores.

"It had been merrily growing away in the mulch," Waghorn says. When he opened the bag, "he couldn't do very much else, unfortunately, but breathe them in."