String instrument players, drummers and pianists are spared the more visceral aspects of playing a wind instrument: the puddles of spit next to each trumpeter’s chair; the swabbing out of every dank crevice in a bassoon or flute; the saturated clarinet mouthpiece. But woodwinds, perhaps, have it the worst, according to research presented at a recent asthma, allergy and immunology conference. If they don’t clean out their instruments on a regular basis, black mold can build up inside and cause a condition called “Saxophone Lung.”

At the conference, researchers described a case of a clarinetist who neglected to clean his instrument for some 30 years and suffered the consequences. Huffington Post provides more details on the story:

The case study detailed a man who was coughing and wheezing when he sought medical treatment at the Emory University Adult Asthma, Allergy and Immunology Clinic. He was initially diagnosed with allergic bronchopulmonary aspergillosis (ABPA). Researchers conducted chest imaging and tested for fungus, and found evidence of infection with different fungi. They also found that his saxophone reed was positive for the fungus Exophiala. The man was given oral steroids, but his condition did not get better until he sterilized his instrument.

The man was misdiagnosed with ABPA for the first year of his illness likely because Saxophone Lung is a pretty rare condition, even among musicians, MedPage Today points out. But that doesn’t mean woodwinds have a free pass to start colonizing a mini-plot of black mold in their instrument, or that brass players shouldn’t assume they’re off the hook, either. One trombone player’s 15-year cough went away only after completely disinfecting his instrument. As the New York Times writes, a colorful array of bacteria, mold and yeasts flourish on mouthpieces of all wind instrument varieties that “ can raise the risk of infections if not routinely cleaned.”

More from Smithsonian.com:

Benny Goodman’s Clarinet

Jazz Man