Most of us have been there. You walk into a room, and there’s a strange smell, or you’re looking at a wall or the ceiling tiles in one of the rooms in your home, and you see visible mold growth. Mold growth is a very common problem in many homes and buildings, typically growing in places with high moisture levels. For most people, mold is an aesthetic issue, but for others, especially those with underlying respiratory issues, exposure to mold can have serious adverse health effects.
As the mold grows, it releases fungal spores, cells, and compounds into the air. These can create allergens and irritants that can be toxic to certain individuals depending on the type of mold.
Aspergillus
One of the most common types of mold is aspergillus. It has many different strains, most of which are harmless. Aspergillus mold exposures are unavoidable. It is found not only in indoor mold but also in trees, plants, and grain crops. This is not an issue for people with healthy immune systems, as any airborne mold spores that are inhaled are quickly killed by the body’s immune cells. However, the health risks for people with specific respiratory issues or a weakened immune system are that these spores might remain in their system and then invade their lungs.
Aspergillosis
Aspergillosis is a non-contagious infection or inflammation caused by aspergillus spores affecting the respiratory tract and system. It rarely affects healthy people, and among the most common symptoms of the infection are a cough that brings up mucus or blood, a high fever, and weight loss.
- Allergic Aspergillosis. People with asthma or cystic fibrosis may find that their asthma attacks worsen. They may also find that the allergic reaction causes them to cough up mucus or blood. These symptoms are caused by an inflammation in the lungs, as opposed to an infection. First line treatment is steroids as opposed to antifungal medications.
- Chronic Aspergillosis. Some patients will develop chronic aspergillosis, where the mold spores cause a lung infection that creates cavities in the lungs. It typically ends up being a long term condition.
- Invasive Aspergillosis. In severe cases of aspergillosis, the infection may spread to the blood vessels. The infection then quickly spreads to the heart, kidneys, or brain for people with weakened immune systems, especially those undergoing chemotherapy or bone marrow transplantation. This form of aspergillosis, known as invasive aspergillosis, can be fatal if left untreated.
Aspergilloma
Aspergilloma occurs when a ball starts to build up in your lungs, made up of fungus, blood clots, and white blood cells. As the ball gets larger, it begins to destroy lung tissue.
Treating Aspergillosis
Depending on the symptoms and severity of the infection, your doctor may choose either to wait and monitor you, prescribe either steroid or antifungal medication, or in more severe cases, perform surgery.
Monitoring is typically used when you are asymptomatic, with your doctor checking for worsening symptoms such as coughing up blood.
If symptoms develop, a healthcare provider may prescribe either steroids or antifungal medication to try to kill off the infection. Steroids are used for allergic aspergillosis while antifungals are used for chronic and invasive aspergillosis. You may end up taking antifungal drugs for many years and possibly your entire life if you’re diagnosed with chronic aspergillosis.
Aspergilloma is typically treated with surgery when it causes bleeding into the lung tissue. This can be a medical emergency and it’s important to seek medical care ASAP if you experience airway bleeding.
Mold can be serious for people with immunosuppressed health conditions and respiratory issues. People with these conditions should avoid places with higher levels of aspergillus mold, such as compost heaps or piles of dead leaves. They should also prevent indoor mold growth by reducing activities that cause high moisture levels, such as drying clothes indoors.
Using air purifiers, especially those with HEPA filters, can also be a good way to lower the risk. Ensure windows are closed on days when dust levels are high or when there is construction. Taking the necessary precautions is the best way to protect your lung health.
Kelly Fan, MD