Mold toxicity: Difference between revisions
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**Penicillium | **Penicillium | ||
**Cladosporium | **Cladosporium | ||
**Aspergillus | **[[Aspergillus]] | ||
**Alternaria | **Alternaria | ||
==Mechanism of Toxicity== | ===Mechanism of Toxicity=== | ||
*Allergy | *Allergy | ||
**More commonly outdoor molds cause allergy but they can be found indoors in cases of excessive water damage | **More commonly outdoor molds cause allergy but they can be found indoors in cases of excessive water damage | ||
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==Clinical Features== | ==Clinical Features== | ||
===Mold Allergy=== | |||
**IgE antibodies against molds can lead to asthma or allergic rhinitis | **IgE antibodies against molds can lead to asthma or allergic rhinitis | ||
**Hypersensitivity pneumonitis is a rare immune response to high concentrations of fungal proteins | **Hypersensitivity pneumonitis is a rare immune response to high concentrations of fungal proteins | ||
* | ===Organic Dust Toxic Syndrome=== | ||
*[[flu-like illness]] between 4-8 hours after heavy exposure to mold | |||
*Symptoms are self-limited and resolve in 24 hours | |||
===Sick Building Syndrome=== | |||
*Vague constellation of neurologic, dermatologic, gastrointestinal, and respiratory complaints attributed to a building's environment | |||
==Differential Diagnosis== | |||
==Evaluation== | ==Evaluation== | ||
*Generally, no specific workup in the ED | |||
**May workup specific symptoms, if deemed appropriate | |||
===Outpatient=== | |||
Consider: | |||
*RAST (Radioallergosorbent) testing can detect IgE mediated allergy | *RAST (Radioallergosorbent) testing can detect IgE mediated allergy | ||
*Air samples and "bulk, wipe, and wall" samples can detect presence of molds | *Air samples and "bulk, wipe, and wall" samples can detect presence of molds | ||
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==Management== | ==Management== | ||
*No Specific drugs or antidotes | *No Specific drugs or antidotes | ||
*Decontamination of environment | *Decontamination and avoidance of environment | ||
==Disposition== | |||
*Outpatient management | |||
==References== | ==References== | ||
Revision as of 04:03, 4 January 2017
Background
- Molds are multicellular fungi that decompose organic matter
- Common household molds:
- Penicillium
- Cladosporium
- Aspergillus
- Alternaria
Mechanism of Toxicity
- Allergy
- More commonly outdoor molds cause allergy but they can be found indoors in cases of excessive water damage
- Infection
- Only a few fungi can infect immunocompetent people: Coccidioides, Blastomyces, Histoplasma, Cryptococcus
- Immunocompromised people are at significant risk even from Candida and Aspergillus
- Toxicity
- Glucans, a component of the cell wall, can produce Organic Dust Toxic Syndrome when inhaled
Clinical Features
Mold Allergy
- IgE antibodies against molds can lead to asthma or allergic rhinitis
- Hypersensitivity pneumonitis is a rare immune response to high concentrations of fungal proteins
Organic Dust Toxic Syndrome
- flu-like illness between 4-8 hours after heavy exposure to mold
- Symptoms are self-limited and resolve in 24 hours
Sick Building Syndrome
- Vague constellation of neurologic, dermatologic, gastrointestinal, and respiratory complaints attributed to a building's environment
Differential Diagnosis
Evaluation
- Generally, no specific workup in the ED
- May workup specific symptoms, if deemed appropriate
Outpatient
Consider:
- RAST (Radioallergosorbent) testing can detect IgE mediated allergy
- Air samples and "bulk, wipe, and wall" samples can detect presence of molds
Management
- No Specific drugs or antidotes
- Decontamination and avoidance of environment
Disposition
- Outpatient management