Pigeon breeder’s disease as a cause of hypersensitivity pneumonitis in a child – A case report

Hypersensitivity pneumonitis (HP) is an immune-mediated lung parenchymal disorder. Pigeon breeder’s disease is the most common form of HP in children, but rarely reported. We report a case of a 12-year-old boy brought to the emergency department with cyanosis and fast breathing. The child had a history of cough for 2 years and progressive dyspnoea for the past 9 months, with exposure to pigeons for the past 3 years. Based on clinical and radiological (high-resolution computed tomography) findings and exposure history, a diagnosis of HP was made, and he was started on oral corticosteroids and supportive care, along with strict avoidance of pigeon exposure. He showed marked clinical improvement on follow-up. Hence, the oral corticosteroids were tapered and stopped after 1 month. This case emphasises the importance of early recognition of HP in children, and timely antigen avoidance and corticosteroid therapy can lead to favourable outcomes, even in resource-limited settings.