Mold toxicity: Difference between revisions
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==Background== | ==Background== | ||
*Molds are multicellular fungi that decompose organic matter | *Molds are multicellular fungi that decompose organic matter | ||
===Common Household Molds=== | |||
*Penicillium | |||
*Cladosporium | |||
*[[Aspergillus]] | |||
*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 | ||
*Infection | *[[Fungal infections|Infection]] | ||
**Only a few fungi can infect immunocompetent people: Coccidioides, Blastomyces, Histoplasma, Cryptococcus | **Only a few fungi can infect immunocompetent people: [[Coccidioides]], [[Blastomyces]], [[Histoplasma]], [[Cryptococcus]] | ||
**Immunocompromised people are at significant risk even from Candida and Aspergillus | **Immunocompromised people are at significant risk even from [[Candida]] and [[Aspergillus]] | ||
*Toxicity | *Toxicity | ||
**Glucans, a component of the cell wall, can produce Organic Dust Toxic Syndrome when inhaled | **Glucans, a component of the cell wall, can produce Organic Dust Toxic Syndrome when inhaled | ||
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==Clinical Features== | ==Clinical Features== | ||
===Mold Allergy=== | ===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=== | ===Organic Dust Toxic Syndrome=== | ||
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
*[[Acute allergic reaction]] | |||
*[[Pneumonia]] | |||
*[[Asthma]] | |||
*Allergic rhinitis | |||
{{ILI DDX}} | |||
==Evaluation== | ==Evaluation== | ||
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==Disposition== | ==Disposition== | ||
*Outpatient management | *Outpatient management | ||
==See Also== | |||
*[[Fungal infections]] | |||
==References== | ==References== | ||
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[[Category:Environmental]] | [[Category:Environmental]] | ||
[[Category:ID]] | |||
Latest revision as of 19:32, 28 September 2019
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
- Acute allergic reaction
- Pneumonia
- Asthma
- Allergic rhinitis
Influenza-Like Illness
- Influenza
- Parainfluenza
- URI
- Pneumonia
- Sinusitis
- Toxic exposure
- Pyelonephritis
- Bronchitis
- Coronavirus
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