I've had recurring sinus, sore throat/ laryngitis, asthma, PND, lower respiratory infections (viral and/or bacterial) since last spring, worse since this past fall. Antibiotics seem to quickly albeit temporarily clear up the green/yellow but other lingering symptoms persist. A few weeks ago I asked for a sputum culture (the results below) which were negative. My GP says it is allergies and quite frankly I feel written off. No pollens/molds in my area at this time and my house is a model allergy home (no carpet, no pets, no excess moisture, HEPA filters, air purifier, etc), I called an indoor air quality company. Found barely trace amts of mold in basement (both air and surface), but found small amounts of aspergillus/pencillium in bedroom (264/m3). Surprising b/c my HEPA air purifier had been running in that room up until about an hour before they got there (it ran all night). This bedroom has bathroom & last spring, we removed the top of the shower bench and found the inside was covered in slimy black/brown mold. The materials inside the bench were cleaned (not removed) and the bench recovered. I'm concerned that the inside of the bench is moist and the mold continues to be active My questions are: 1) Is asp/pencili only an allergen? It doesn’t cause other damage?; 2) Hubby feels we can’t see or smell the mold and that the spore levels of 264 (after air purifying BTW) are so low they should not be the cause of my symptoms. Are the "spores" the only aspect of mold that acts as an allergen or irritant?
I want the air quality people to come back out & test the inside of the bench because I want to know what's in there. Any insight or suggestions either for them or for me (medically) would be appreciated as I'm left to think of all the possible issues on my own. Thanks!
SPECIMEN DESCRIPTION: SPUTUM; SPECIAL REQUESTS: NONE; GRAM SMEAR: MANY WBC'S SEEN ; GRAM SMEAR: RARE MIXED ORAL FLORA OBSERVED ; CULTURE: SMALL AMOUNT NORMAL RESPIRATORY FLORA ISOLATED
You have provided a good description of your circumstance and what has transpired. You asked the following: “My questions are: 1) Is asp/pencili only an allergen? It doesn’t cause other damage? 2) Hubby feels we can’t see or smell the mold and that the spore levels of 264 (after air purifying BTW) are so low they should not be the cause of my symptoms. Are the "spores" the only aspect of mold that acts as an allergen or irritant?”
Aspergilla is not just an allergen. It is also a potentially tissue-invasive infectious agent (almost exclusively in persons whose immune system is compromised) but, as such, is rarely seen in individuals who have a normal, intact immune system. In otherwise healthy individuals, including those with asthma, Aspergilla almost always functions as an allergen. It takes several physical forms, including Conidia (spores) that germinate and are transformed into hyphae. There is not necessarily a good correlation between spore count levels and the likelihood of lung disease in exposed individuals. The fact that you can’t see or smell the fungus does not preclude its being a factor in lung disease.
Demonstration of the fungus in one’s environment may be useful but equally or even more important would be the demonstration of the organism in ones airways. Sputum culture negativity must be interpreted in the context of how the sputum was cultured and the microbiological quality of the laboratory doing the testing.
This is a specialized area of lung disease that is beyond the scope of even many high quality specialists in general Pulmonary Disease, or Allergy. To be optimally diagnosed and treated, requires the expertise of specialists in Environmental Medicine and/or Infectious Disease, ideally with a special interest in the field of lung disease caused by fungi. Such physicians are to be found a many major academic medical centers including the Mayo Clinic, the Cleveland Clinic, the University of Pittsburgh and (my institution) National Jewish Health in Denver, Colorado (formerly National Jewish Medical and Research Center). You might begin by asking your GP if he/she knows of such persons in your geographical area.
I strongly suspect that you have a treatable disease.
I'm not sure if the Doc can see this follow up post. But I went to see my Allergist today who says my shower/water problem is a problem but won't solve my problem. I need to go back on allergy shots. I did them about 6 years ago and I didn't find they helped that much. Is there reason to try them again??
You have had recurring infections for several months. You may want to go see an ENT doctor and ask their opinion about getting a middle turbinate biopsy considering a diagnosis of chronic fungal sinusitis.
Diagnosis of chronic fungal sinusitis? No one has diagnosed that. In fact, my GP said that fungal infections are so rare, not even considered in my case. And according to her my sputum culture came back normal. I do have an appt. with an ENT. According to my Allergist a CT Scan from a few years back showed I have extra sinuses??? Never knew. But he said I should get them checked out.
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