Mold toxicity

Revision as of 04:09, 4 January 2017 by Rossdonaldson1 (talk | contribs) (Common Household Molds)

Background

  • Molds are multicellular fungi that decompose organic matter

Common Household Molds

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

Influenza-Like Illness

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

See Also

References