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Extrinsic allergic alveolitis (EAA) is not a uniform disease entity, but rather a complex dynamic clinical syndrome that varies in its initial presentation and clinical course [2]. Fink et al. have described EAA as occurring in acute, subacute and chronic forms [3]. The authors do not however specify how many of the patients presented with the acute, subacute or chronic course of the disease. An alternative classification system that emphasises the dynamic nature of the disease with acute progressive, acute inter­ mittent non­progressive and recurrent non­acute disease has been proposed [4]. However, the authors did not identify the course of disease in their patients. The study noted that in all of the patients crackles were audible upon respiration. Was there no wheezing heard in the patient with airway obstruction? Characteristics of the exposure to bird spe­ cific antigens, such as time or duration are not well documented in the study. For the majority of patients with pigeon breeder’s lung in Poland contact with birds is a hobby and after diagnosis of disease avoidance of the causative antigen is usually easily achievable. It is more difficult however for patients with farmer’s lung, since farmers work in harmful conditions because this work is the source of their livelihood [5]. It was not clearly stated but it would be beneficial to know; how many patients completely restricted contact with the causative antigen? It is not clear what treatment was administrated following dia­ gnosis of EAA in this group of 15 patients. Were there patients in this group treated with cortico­ steroids? It is important to know if patients with clinical symptoms and functional or radiological abnormalities were exposed to antigens.

Bird Fancier’s Lung—Comment on: Kumar R., Singh M. “Bird Fancier’s Lung: Clinical-Radiological Presentation in 15 Cases”