Environmental Engineering Reference
In-Depth Information
designed to determine sensitivity to mold have limited reliability. There is
evidence to suggest that sensitivity to mold enhances symptoms associated
with other allergens.
2. Allergic fungal sinusitis
This is a mold-induced disease of the paranasal sinuses. It may include both
noninvasive and invasive (penetrates tissue) forms. It commonly occurs in
atopic (i.e., allergy-prone) individuals who have rhinitis, nasal polyps, or
asthma. In the noninvasive form, sinus membranes thicken and produce an
exudate that contains mucinous plugs, eosinophils, and cellular debris;
recurrent sinusitis symptoms do not respond to antibiotic therapy. Genera
reportedly associated with allergic fungal sinusitis include
Aspergillus, Cur-
vularia, Alternaria,
and
Bipolaris.
3. Allergic bronchiopulmonary mycosis
This ailment results from immune reactions to fungi that have colonized
respiratory airways. It is characterized by recurrent pulmonary edema (fluid
production), chronic swelling and destruction of affected bronchial tubes,
fibrosis, and elevated serum immunoglobin levels. A reduction in total lung
volume occurs, reducing the infected individual's breathing capacity.
Aspergillus fumigatus
is the most common fungal species associated with
allergic bronchiopulmonary mycosis.
Candida, Curvularia,
and
Helminthospo-
rium,
as well as other species of
Aspergillus,
have also been reported to cause
this illness.
Individuals with this disease almost universally have an atopic history.
It affects approximately 0.5 to 1% of asthmatics and 10 to 15% of individuals
with cystic fibrosis.
4. Asthma
Asthma can be induced by exposure to mold allergens. As with chronic
allergic rhinitis, the prevalence rate of mold-induced asthma is unknown.
Because of the limited number of well-prepared diagnostic extracts that are
available to physicians, mold sensitization is difficult to confirm. It is likely
that fungal species that cause chronic allergic rhinitis also cause asthma.
5. Hypersensitivity pneumonitis
Hypersensitivity pneumonitis, as indicated previously (Chapter 5), can be
induced by exposure to a variety of organic dusts. Such dusts include fungal
spores as well as mycelial fragments. Best known are cases associated with
specific occupations. These include malt worker's lung associated with
Aspergillus
, cheese worker's lung associated with
Penicillium
, sequoiaosis
associated with
Aureobasidium
, and outbreaks of hypersensitivity pneumoni-
tis associated with ventilation systems.
