NIH website: Children and Pulmonary Hemorrhaging (Which I believe was changed later)

[Guest guest]

http://ehp.niehs.nih.gov/members/1999/107p927-930flappan/flappan-full.html

M. Flappan, Jay Portnoy, , and

Department of Allergy, Asthma, and Immunology, Children's Mercy Hospital, Kansas

City, Missouri, USA

Introduction

Case Presentation

Methods

Results

Environmental Remediation

Discussion

Conclusion

Abstract

The American Academy of Pediatrics recently issued guidelines regarding the

potential toxic effect of indoor molds. We now report another case of an infant

with pulmonary hemorrhage whose residential environmental assessment revealed

the presence of the toxigenic mold Stachybotrys atra. We used a questionnaire to

identify environmental factors that could predispose the home to fungal

contamination. We collected air samples from multiple locations in the home that

we felt would reflect areas of relevant exposure. Surface samples were collected

with a piece of transparent tape for semiquantitative measurement of spores

present. We classified spores into their respective genera based on shape, size,

and color. We also measured mycotoxin levels. Air sampling revealed

significantly elevated total spore counts in the patient's bedroom and in the

attic. Aspergillus/Penicillium species were predominant. Stachybotrys spores

were found in the air sampled in the patient's bedroom, as well as

from surfaces sampled in the patient's closet and the attic ceiling.

Additionally, a small patch of Stachybotrys-contaminated area in the closet

ceiling was sent for mycotoxin analysis. This material proved to be highly

toxigenic. As the link between the presence of Stachybotrys in the home and

pulmonary hemorrhage in infants increases, further efforts should be made to

educate physicians, health care providers, and new parents about the potential

toxic effects of this mold. Key words: floods, fungus, idiopathic pulmonary

hemorrhage, IPH, mold exposure, mycotoxins, Stachybotrys, toxic mold,

tricothecenes, water damage. Environ Health Perspect 107:927-930 (1999). [Online

20 October 1999]

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