March 13, 2013 at 11:56 AM ET
A high-profile bagpipe player from rural England is back in tune after a nearly fatal infection with fungal pneumonia that doctors say sprang from spores that grew inside his beloved instrument.
John Shone, 78, of Wiltshire, is warning other players to be sure to disinfect their bagpipes after he fell ill last fall with a mysterious ailment that initially resisted most drugs -- and the best efforts of the medical team treating him.
“Failing to clean my pipes led to me becoming critically ill,” said Shone, who shared his tale in the March issue of the Piping Times, the magazine produced by the College of Piping in Glasgow, Scotland.
"It is very important for pipers worldwide to clean their instruments," he told NBC News in a telephone interview.
Shone, who has played since childhood, is an expert in piobaireachd, the classic music of the Highland bagpipe. He practices daily, but had not cleaned the instrument for at least 18 months because it was sounding so fine and he was preparing for an important performance. Bagpipes are notoriously tempermental and the smallest change in the environment can alter the tone, Shone said.
But that was before doctors were stumped by the infection that landed the elder Shone at Salisbury Hospital, twice, including a four-week stint starting last October. He got so sick and weak he couldn’t walk and lost more than a stone in weight -- or about 14 pounds.
“I will have to buy a new kilt,” Shone wrote.
Desperate, doctors asked about Shone’s hobbies and other outside interests. When they learned he was a bagpiper, the medical crew asked to test the instrument – and found the culprit.
“The ‘path lab’ reported they had grown a large number of fungi easily and that the deadly fungus that had infected my lungs was amongst them,” Shone said.
Those included the Rhodotorula and Fusarium species, which can cause infections that kill half of the people stricken by them.
Apparently the synthetic bags favored by modern pipers are an ideal environment for bacteria, mold and fungus that can grow in saliva that gets into the bags during playing. Old-time pipers used hide bags that required regular maintenance, procedures that probably kept them clean and safe, Shone said.
That kind of maintenance is, indeed, critical, noted Maclean Macleod, president of the U.S. Piping Foundation in Newark, Del.
“A piper who’s a piper keeps his instrument as clean as a whistle,” Macleod said.
Shone has recovered enough that he was playing his pipes in London earlier this week, he said. Reports of bagpipe infections are rare, but a 1978 article in The Lancet documented a fungal infection caused by Cryptococcus neoformans found in the patient’s instrument.
And while there’s scant research on rates of infection among musicians, there have been other reports of illnesses tied to instruments. A 35-year-old man suffered from so-called “trombone player’s lung,” or hypersensitivity pneumonia triggered by bugs including the same Fusarium fungi that affected Shone. The trombone player had a bad cough that lasted for 15 years, according to a 2010 article in the journal Chest. His cough stopped once he started disinfecting it with rubbing alcohol. Another musician, a 48-year-old saxophone player, also suffered from lung problems triggered by molds until he started washing his mouthpiece, according to a 2010 article also in Chest.
Shone’s symptoms made sense to Dr. Stuart Levy, a Tufts University professor of molecular biology and microbiology.
He and a colleague tested 20 instruments and found that germs can live for from a few hours to several days on wind instruments such as clarinets, flutes and saxophones. A deactivated strain of tuberculosis bacteria survived for up to 13 days, according to the study in the International Journal of Environmental Health research.
“I’m not surprised with the data,” Levy said of Shone’s bagpipe pneumonia. “I’m just surprised that the event is so uncommon.”