Fungal Hypersensitivity: Pathophysiology, Diagnosis, Therapy


Marinkovich VA

Date: 2 March 2008


The comments contained herein are those of a clinical immunologistwhose major professional activity is patient care. Over the last severalyears, as the general awareness of fungal exposure as a cause of illnesshas grown, more and more patients have been presenting themselvesfor diagnosis and treatment after exposure to homes and offices heavilycontaminated by fungi. The Internet has come to play a major rolein the dissemination of good, and some not so good, informationabout fungal diseases, and the number of patients has mushroomed.Most American trained physicians have had little instruction in mycologyand tend to dismiss or minimize the possibility of fungal illnessexcept for certain generally accepted special situations. These wouldinclude immunologically deficient patients, Candida infections inwomen, thrush in newborns, skin infections such as ringworm andathlete’s foot, and lung infections in areas endemic for histoplasmosisor coccidioidomycosis. Even allergists who limit themselves to skintests for diagnosing hypersensitivity ignore patients complaining ofserum sickness-like symptoms (e.g., headaches, rash, malaise, jointpain, etc.) following exposure to moldy environments and often referthem for psychiatric care (Terr, 2001). The unfortunate patient hasnowhere to turn except to those few physicians who have listenedto their patients, believe what they say, and accept the challenge totry to help. These physicians have gone to the Internet or the medicalliterature and developed scientifically inspired diagnostic and treatmentprograms that have proven to be helpful to their patients. I standamong these physicians, and I would vigorously defend the scientificbasis and efficacy of my approach to the diagnosis and treatmentof patients suffering from exposure to high ambient levels of fungi inindoor environments. My best thoughts on the subject are offeredherein.

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