Indoor mold, toxigenic fungi, and Stachybotrys chartarum: Infectious disease perspective

Damp buildings often have a moldy smell or obvious mold growth, some molds are human pathogens. This has caused concern regarding health of moldy envoirments and has resulted in many studies of moisture- and mold-damaged buildings. Recently, there have been reports of severe illness as a result of indoor mold exposure, particulary due to Stachybotrys chartarum nile many authors describe a direct relationship between fungal contamination and illness, close examination of the literature reveals a confusing picture Here we review the evidence regarding indoor mold exposure and mycotoxicosis, with an emphasis on S. chartarum. We also examine possible end-organ effects, including pulmonary, immunologic, neurologic, and oncologic disorders. We discuss the Cleveland infant idiopathic pulmonary hemorrhage reports in detail, since they provided important impetus for concerns about Stachy-botrys. Same valid concerns exist regarding the relationship between indoor mold exposure and human disease, Review of the literature reveals certain fungus-disease associations in humans, including ergotism (Claviceps species), alimentary toxic aleukia (Fusarium), and liver disease (Aspergillys). While many papers suggest a similar relationship between Stachybotrys and human disease, the studies nearly uniformly suffer from significant methodological flaws, making their findings inconclusive. As a result, we have not found well-substantiated supportive evidence of serious illness,due, to Stachybotrys exposure in the contemporary environment. To address issues of indoor mold-related illness, there is an urgent need for studies using objective markers of illness, relevant animal models, proper epidemiologic techniques, and examination of confounding factors.