Dry-snuff Induced Chronic Hypersensitivity Pneumonitis: A Case Report

Dry nasal snuff, commonly known as “Chhikni” in India, is a smokeless tobacco preparation prepared from dried powdered tobacco which could be inhaled, "sniffed" or "snuffed" into the nasal cavity [1]. The inhalation of nasal snuff (smokeless tobacco) is a common addiction in rural India. In the western world, there is a resurgence of interest in the use of nasal snuff. Very few cases have been reported regarding long-term effects of nasal snuff on lung parenchyma. We hereby present the case of a 67-year-old woman who developed chronic hypersensitivity pneumonitis because of sniffing dry snuff. She sniffed dry snuff for 30 years about four to five times a day. She was successfully treated with corticosteroids and was discharged on home based minimal O2 support. This case report aims to emphasizes on the respiratory complications associated with snuffing noxious substances and considering hypersensitivity pneumonitis as a possibility.