Mold Guide

Aspergillus

Most common indoor fungus and often associated with mold contamination. Grows on spoiled foods and other organic debris. Very tolerant of high heat and high humidity. Found in bathrooms and drip pans underneath refrigerators.

Penicillium

Very prevalent. Most often associated with indoor mold contamination. Grows on spoiled food, cheese and in various wines. Commonly found in carpet, wallpaper, paint, interior fiberglass, duct work and other organic debris in damp buildings. Allergic sensitivity to this form of mold does not constitute an allergy to penicillin-based antibiotics.

Rhizopus

Prominent in damp interiors. Contaminant of bread and sugary foods. Often linked to occupational allergy

Alternaria

Most common fungus identified in outdoor air samples. Indoor counts are relative to outdoor levels. High levels may trigger acute asthma attacks. Found on leaves, plants and other decaying organic materials. Often found on window frames.

Hormadendrum

One of the most common fungi indoors, but generally comes from outdoors. Numbers are high in summer and are reduced in winter. Found in compost and in decaying plants and vegetables.

Epicoccum

Common mold found in plants, soil, grains, textiles and paper products.

Fusarium

Found in soil and on plants. More common during wet and damp weather. Frequent contaminant of humidifiers. Visible pink mold in showers and tubs.

Mucor

Found in damp interiors. Contaminant of bread and sugary foods. Found outside in soil, dead plant material and horse dung.

Phoma

Found on plant materials and soil. Produces pinkish purple spots. Commonly found on painted walls, shower walls, cement and rubber materials.

Trichophyton

Found in soil and on skin. May cause ringworm.

Candida

Part of the normal microbes (flora) of the mouth and other mucous membranes of the human body.

Allergy Treatment

Understanding Allergy Testing

Skin Testing

Skin tests are the most accurate and reliable form of allergy testing. Extracts of various substances – known as allergens – are applied to the skin surface and observed to see if a positive reaction occurs. A raised area will appear where the allergen has been applied. The larger the reaction, the more allergic you are to that particular allergen.

Food Testing

Food testing is done through two different type venues. Food Challenge is the safest and most reliable type of food testing. With this type of testing, the suspected food is removed from the diet for a length of time to see if the allergic symptoms decrease and then reintroduced back into the diet to see if symptoms reoccur. This will allow the patient to gain knowledge of which foods to avoid. Blood Testing (RAST) is done through a blood draw and sent to a laboratory for analysis. Please allow 10-12 business days for these result to return. These types of testing will be considered and ordered by your physician depending on your medical history.

Caring for Skin Testing Sites

Skin testing sites are not usually painful after testing. However, some individual sites may itch, become enlarged, and have a red appearance. It may take several hours, days, and possibly weeks before the sites completely fade. The sites should be kept clean by washing with soap and water. If itching persists, the patient can apply hydrocortisone cream and take an over-the-counter antihistamine such as Benadryl®. Prolonged swelling and soreness can be treated with ice packs and an anti-inflammatory medication such as Ibuprofen®, Motrin®, Advil®, etc. If a more serious reaction occurs, please seek medical treatment at your nearest primary care facility or emergency room.

Inhalants

There are numerous substances commonly found in our common everyday environment which can cause symptoms in allergic individuals upon exposure to them. These substances are called allergens. They are extremely small particles which float in the air and can only be visualized under a microscope. Exposure to the majority of these allergens occurs through inhalation, which results in reactive allergic response of the respiratory tract. This encompasses the nose, throat and lungs. Other closely related organs are the eyes and ears.

Common Indoor Inhalants

Dust Mite - The common household mite is a tiny microscopic organism found worldwide living in mattresses, pillows, carpets and upholstered furniture. It is harmless, feeding off shed human skin flakes, but has been found to be a major inhalant allergen in susceptible individuals. Mites are one of the most common causes of allergies, especially in those individuals with asthma. Mites increase in numbers with high humidity.

Cockroach - This common household insect can pose a problem for those individuals with inhalant allergies. The remnants of the outer hard shells and the waste products of cockroaches often cause allergic symptoms in up to 1 out of 2 individuals. They are found as a component of common household dust. They are especially a common trigger for allergic reactions in those with asthma.

Pets - The invisible microscopic particles of skin (dander) are the cause of animal allergies. Shed hair is not the problem, therefore short haired pets and non shedding pets are still responsible for causing allergic reactions. There are no "hypo-allergenic" animals and chihuahuas do not "take away" the symptoms of asthma. Cats pose the most allergic reaction in susceptible individuals. Cat allergen is most prevalent in their saliva and sweat glands, which dries on the cat's fur and flakes off into the air. It may take years after the removal of the animals from the home for levels to decrease enough to where it will not cause allergic reactions.

Tobacco Smoke - Tobacco smoke is not a "true" allergen within itself. It is the numerous chemicals that are present in smoke that cause the allergic reactions. Secondhand exposure to cigarette smoke has been shown to increase the incidence of upper respiratory infections, including ear infections and recurrent sinusitis. Asthma and pneumonia are also triggered by repeated exposure to cigarette smoke. Exposure to any type of tobacco smoke should be avoided by all allergic and asthmatic individuals.

Latex - Latex is the sap produced from the rubber tree (Hevea brasiliensis) and is used in the manufacturing of natural rubber products such as gloves, bandages, tapes and balloons. Any individual may become sensitized to latex, however, those with a higher risk are those who work in the health care industry. Patients who have had multiple operations and those with occupational exposure to manufactured rubber products pose a higher risk. Allergy to certain foods – bananas, avocado, kiwi and chestnuts are commonly seen in a patient with a latex allergy. If you think you may have allergic sensitivities to latex, a simple blood test can be performed to determine if you are in fact allergic.

Tree Pollens - Tree pollen may first be present in the atmosphere in late February or March and will continue through May. These pollens account for the seasonal allergy symptoms seen in early spring. Tree groupings and pollinating times are provided for the patient. (Refer to the Positive Skin Testing Results portion of this handout.) Early trees pollinate in late February through early April. Late trees pollinate in mid-April through May.

Grass Pollens - Grass pollens are released into the air during the months of May and June and account for significant allergic symptoms during the late spring and early summer.

Weed Pollens - Weed pollen is produced by various common weeds and may produce allergic symptoms in reactive individuals. Weed pollen counts are at the highest levels in late summer and early fall, and remain active until the first killing frost. Ragweed pollen accounts for over 90% of the weed pollen found in the atmosphere during the months of August and September.

Foods - Positive reactions to foods may or may not be significant. If ingestion of a particular food has resulted in an allergic reaction, then you should avoid that food. If ingestion of the specific food does not correlate with clinical symptoms, then the physician may suggest eliminating the food for a specific time and then reintroducing it back into the diet. This is known as a food challenge.

Molds - Fungi are often considered to belong to a kingdom of organisms completely separate from the plant and animal kingdoms. They often exist in extremely large numbers in most every type of environment. Fungi produce tiny spores that become airborne, and when inhaled may produce allergic reactions. Mold allergy contribute to 25-30% of all allergic and asthmatic reactions.

Understand Serious Reactions/Anaphylaxis

While most allergic reactions aren't life threatening, there is one type that can be. Anaphylaxis causes breathing difficulty and loss of consciousness, among other dangerous symptoms. It usually occurs within minutes of contact with an allergen, a substance that causes an allergic reaction.

Anaphylaxis affects the whole body. Symptoms can include flushed skin, rash, swelling, a stuffy nose, sweating, paleness, panting, nausea, abdominal cramps, rapid pulse, faintness, confusion, wheezing, convulsions and fainting. Additional symptoms are itching of the mouth, tightness of the throat, hoarseness and feeling the need to urinate. Please administer your EpiPen®, call 911, and get to the nearest emergency room.

You can now receive additional information detailing each antigen for which you were tested. Go to our website, PurchaseEnt.com, and click on the fact sheet icon. Then click on the Antigen icon under the heading Allergy. This will show you all of the antigens for which we use in our testing in alphabetical order. You can then correlate the antigen on your testing result sheet to the fact sheet on the website. Any antigen with an endpoint of#3 or above is considered positive. These are the antigens in which your physician will consider if treatment is recommended. This will be very helpful to you by giving you some substantial information in regards to adverse reactions and occupational exposure.

At Purchase ENT, we take our patients’ health, treatment and safety to heart. If you have any further questions, please feel free to contact our allergy department. Thank you for allowing Purchase ENT to be a participant in your healthcare.

Todd A. Spann

Allergy Department Coordinator