דו״ח מאומת

This is a case report of hypochondrical paranoia in a young man, who was convinced of a toxic infection by fungi following mold growth exposure. The patient was admitted to a psychiatric facility, severely pained by the delusional perception of his insides being eaten by fungus. He had undergone a thorough medical examination without the discovery of any somatic irregularities and had attempted to treat himself several times. After four months of hospital-ization and the prescription of antipsychotic treatment, he was in recovery. Mild delusions persisted but were no longer pathologically painful.…

PMID: 29493502

Disseminated fungal infection (DFI) is uncommon in the general population but represents a severe and frequently fatal complication in immunocompromised patients, particularly those with hematologic malignancies and prolonged neutropenia. In high-risk settings, invasive fungal infections occur with clinically meaningful frequency; a large systematic review of critically ill patients reported a pooled prevalence of invasive fungal infection of approximately 5%, highlighting that while DFI is uncommon in the general population, serious fungal disease is encountered more frequently in select high-risk cohorts. We report a case series of three immunocompromised patients with DFI to highlight shared clinical patterns, diagnostic limitations, and poor outcomes. Two patients developed disseminated fusariosis with pulmonary nodules and characteristic necrotic cutaneous lesions, while the third developed <i>Scedosporium prolificans</i> fungemia with pulmonary involvement and progressive encephalopathy concerning for early central nervous system (CNS) dissemination. Diagnosis required a multimodal approach, including tissue biopsy, bronchoalveolar lavage (BAL), blood cultures, and advanced molecular testing; however, precise quantification of diagnostic delay was not systematically available across cases. In this series, diagnosis was nonetheless delayed relative to initial clinical presentation, largely due to nonspecific radiographic findings, initially negative or indeterminate cultures, overlap with bacterial or noninfectious etiologies, and the need for invasive sampling in profoundly cytopenic patients. Management was further limited by intrinsic antifungal resistance, drug toxicity, and failure of immune recovery; despite aggressive therapy, all patients experienced rapid clinical deterioration over days to weeks following diagnosis, culminating in death or transition to hospice care. These cases underscore the aggressive nature of DFI in profoundly immunocompromised hosts, the central role of neutropenia in facilitating dissemination, and the need for early recognition, multidisciplinary management, and timely goals-of-care discussions when DFI occurs in the setting of advanced immunosuppression.…

PMID: 41878180

Blastomycosis is a dimorphic fungal infection caused by <i>Blastomyces dermatitidis</i> and related species, classically presenting with pulmonary and cutaneous involvement. Musculoskeletal manifestations, particularly monoarthritis, are rare and diagnostically challenging. We present the case of a previously healthy 41-year-old man who developed nodular skin lesions, cough, pulmonary nodules and persistent left knee arthritis, initially thought to be due to pseudogout. The diagnosis of disseminated fungal infection was suggested by CT scan, skin biopsy, and confirmatory fungal culture that grew <i>Blastomyces dermatitidis.</i> This case highlights the atypical pattern of joint involvement, the need to expand the differentials as dictated by clinical signs, the role of multidisciplinary collaboration, and the diagnostic utility of skin biopsy and fungal culture.…

PMID: 41788724

Fungal allergy including allergic rhinitis, conjunctivitis, bronchial asthma, and allergic bronchopulmonary mycoses results from exposure to spores. In this review we have dealt with the common allergenic fungi and allergens, immunopathogenesis, diagnostic assays, and the possible control of allergy in the future based on epitope-specific immunotherapy and vaccination.…

PMID: 10967290

Animal farming is associated with exposure to organic dust containing allergens, endotoxins, and alive microbial organisms. Microbial Volatile Organic Compounds (MVOCs) produced mainly by fungi and bacteria pollute the air and accumulate particularly in confined animal buildings, posing serious health hazards to workers, including veterinarians. The exposure can lead to rhinitis, chronic bronchitis, asthma, and chronic obstructive pulmonary disease (COPD). In a range of cross-sectional studies, wheeze and asthma were associated with exposure to swine, dairy cattle, horse, and sheep, but also to more specific exposures like manure. Occupational asthma has been reported in agricultural workers, including veterinarians. We report two cases of veterinarians who developed asthma in relation to prolonged and intense contact with sheep. No specific allergens could be found, MVOCs were considered as the causative agents.…

PMID: 41631187

Rhinitis is a very common disorder caused by inflammation or irritation of nasal mucosa. Dominant symptoms are nasal obstruction; however, in some patients, runny nose, excessive sneezing or nasal itch may be the most bothersome symptoms. The most common causes of nasal inflammation are viral infections and allergic response to airborne allergens. Response to irritants may cause similar symptoms, although signs of inflammation may not always be present. Viral rhinitis is lasting up to 10 days and it is part of the common cold syndrome. In short-lived rhinitis, lasting for 7 to 10 days, sometimes it is not easy to differentiate between the potential causes of the disorder, if general symptoms of infection like fever and malaise are not present. In long-living rhinitis, it is important to differentiate between infectious, allergic, non-allergic non-infectious rhinitis, and chronic rhinosinusitis. Itch and ocular symptoms are more common in allergic rhinitis, while other symptoms like nasal obstruction, rhinorrhea and sneezing may affect patients with allergic and non-allergic rhinitis. Patients with allergic rhinitis often have symptoms after exposure to irritants, temperature and humidity changes, like patients with non-allergic rhinitis, and such exposure may sometimes cause more severe symptoms than exposure to allergens. Sensitivity to a non-specific trigger is usually called non-specific nasal hyperreactivity. Allergic rhinitis occurs due to immunoglobulin E (IgE) interaction with allergen in contact with nasal mucosa in a sensitized patient. Sensitization to certain airborne allergen, like pollens, dust, molds, animal dander, etc. usually occurs in families with allergy background, which is helpful in making diagnosis in patients who have rhinitis in a certain period of the year, or aggravation of nasal symptoms occurs in the environment typical of certain allergen. The diagnosis is clinically confirmed by proving sensitivity to certain allergen on skin prick test, and by proving specific antibody IgE in patient serum. Allergic rhinitis is categorized according to sensitivity to allergens that occur seasonally, like pollens, or to allergens that are present all year round, like house dust mite, molds and animal dander, into seasonal and perennial allergic rhinitis. Allergy to pollens causes the same mechanism of inflammation in response to allergens, which is the result of allergen binding to specific IgE antibody; however, patients with pollen allergy usually complain more of sneezing and runny nose, whereas patients with allergy to perennial allergens more often complain of obstruction, with the episodes of sneezing and runny nose occurring only when exposed to higher concentrations of allergens (house cleaning, around pets). Treatment includes avoidance of allergens, medical treatment and immunotherapy (allergy vaccines, tablets with allergens). Avoidance of allergens means reduction of environmental allergen load to the respiratory system including workplace, which is not easy to accomplish. Medical treatment is usually necessary to control symptoms, and it includes antihistamines, nasal or in tablets, and nasal glucocorticoids (steroids). Antihistamines should be second generation, which do not cause sedation, and such treatment shows more efficacy on runny nose, sneezing and nasal itch than on nasal stuffiness. Nasal steroids are more potent in improving nasal patency than antihistamines, and are at least as potent in the control of all other nasal and ocular symptoms. Nasal patency may be improved by nasal or oral decongestants, but such treatment should be reduced to as short period as possible, since after several days of using nasal decongestants rebound congestion may occur and patients will need nasal decongestants to improve nasal airways even when allergens are not around anymore.…

PMID: 22359885

The perceived Indoor Air Quality (IAQ), the prevalence of Sick Building Syndrome (SBS) symptoms and its contributing risk factors were assessed in a university during the period of the economic crisis in Greece. Data was collected from 613 employees via questionnaires. Hierarchical linear regression analysis was performed. The most prevalent perceived IAQ complaints were 'Dust and dirt' (63.2%), 'Room temperature too low' (24.9%) and 'Varying room temperature' (24.4%). The most frequently reported SBS symptom was 'Fatigue' (34.1%). The prevalence of General, Mucosal and Dermal symptoms was 40.8%, 19.8% and 8.1%, respectively. Several contributing risk factors were identified, such as IAQ Discomfort Scale, atopy, sleep problems, female, exposure to biological and chemical agents, PC-use, Psychosocial Work Scale and job satisfaction. Poor perceived IAQ and high prevalence of SBS symptoms were reported from the university staff in a temperate climate country. SBS seemed to be multifactorial.…

PMID: 32633551

Sick Building Syndrome (SBS) is an illness among workers linked to time spent in a building. This study aimed to investigate the Indoor Air Quality (IAQ) and symptoms of Sick Building Syndrome (SBS) among administrative office workers. The IAQ parameters consist of ventilation performance indicators, and physical and chemical parameters were measured using specified instruments for three days during weekdays. The SBS symptoms were assessed by a questionnaire adopted from the Industry Code of Practice of Indoor Air Quality (ICOP-IAQ) 2010 among 19 employees from the office in East Coast Malaysia. Relationship between past symptoms and present symptoms which are draught (past symptoms) with feeling heavy headed (present symptoms) (…

PMID: 38665133

Indoor air quality (IAQ) influences human health, productivity and wellness. Green buildings are believed to have better IAQ. The 'sick building syndrome' (SBS) describes a set of nonspecific symptoms experienced by occupants due to time spent in a building with poor IAQ. Thus this study was undertaken to assess the IAQ in green buildings and compare it with that of conventional buildings. The prevalence of SBS in both types of buildings is also studied. In five pairs of green and conventional buildings measurements of comfort parameters (temperature & relative humidity) and indoor air pollutants using monitors was done. 148 employees which included 84 from green buildings and 64 from conventional buildings were surveyed for SBS using an interviewer-administered questionnaire. The analysis was done using SPSS16 and included Mann Whitney for IAQ pollutant concentrations and Chi-square for the SBS prevalence. Similar indoor air quality was found in both types of buildings. The mean of temperature, CO2 and formaldehyde was statistically lower in green buildings. The SBS prevalence was found to be 38.1% in green buildings and 53.1% in conventional buildings. Thus to conclude the poorly maintained green building does not have any added advantage for occurrence of SBS.…

PMID: 32435112

Sick building syndrome (SBS) encompasses a range of non-specific symptoms experienced by occupants, commonly associated with poor indoor air quality (IAQ). This study investigated the associations between IAQ parameters and SBS symptoms among 124 office workers across six bank offices in Malaysia. Indoor PM2.5, PM10, CO2, TVOC, formaldehyde, temperature and relative humidity were measured using validated instruments, while SBS symptoms were assessed using standardized questionnaire adapted from the Industry Code of Practice of Indoor Air Quality (ICOPIAQ) 2010. Findings revealed that banks using split-unit air conditioning (AC) ventilation had higher concentration of PM2.5 and CO2, exceeding the recommended standards, compared to those using air-conditioning and mechanical ventilation (ACMV) ventilation type. The most prevalent symptoms were headache (47.6 %), cough (44.4 %), irritated and stuffy nose (38.7 %), irritation of eyes (35.5 %), fatigue (25 %), dizziness (25 %), feeling heavy-headed (24.2 %), and skin rash or itchiness (24.2 %). Among these, dizziness was significantly associated with PM2.5, PM10, CO2, and formaldehyde levels. These findings highlight the need for improved ventilation and IAQ management in bank offices. Public policies and interventions at organizational level are essential to mitigate SBS risks and safeguard worker health.…

PMID: 41140948

Fungal allergy including allergic rhinitis, conjunctivitis, bronchial asthma, and allergic bronchopulmonary mycoses results from exposure to spores. In this review we have dealt with the common allergenic fungi and allergens, immunopathogenesis, diagnostic assays, and the possible control of allergy in the future based on epitope-specific immunotherapy and vaccination.…

PMID: 10967290

Rhinitis is a very common disorder caused by inflammation or irritation of nasal mucosa. Dominant symptoms are nasal obstruction; however, in some patients, runny nose, excessive sneezing or nasal itch may be the most bothersome symptoms. The most common causes of nasal inflammation are viral infections and allergic response to airborne allergens. Response to irritants may cause similar symptoms, although signs of inflammation may not always be present. Viral rhinitis is lasting up to 10 days and it is part of the common cold syndrome. In short-lived rhinitis, lasting for 7 to 10 days, sometimes it is not easy to differentiate between the potential causes of the disorder, if general symptoms of infection like fever and malaise are not present. In long-living rhinitis, it is important to differentiate between infectious, allergic, non-allergic non-infectious rhinitis, and chronic rhinosinusitis. Itch and ocular symptoms are more common in allergic rhinitis, while other symptoms like nasal obstruction, rhinorrhea and sneezing may affect patients with allergic and non-allergic rhinitis. Patients with allergic rhinitis often have symptoms after exposure to irritants, temperature and humidity changes, like patients with non-allergic rhinitis, and such exposure may sometimes cause more severe symptoms than exposure to allergens. Sensitivity to a non-specific trigger is usually called non-specific nasal hyperreactivity. Allergic rhinitis occurs due to immunoglobulin E (IgE) interaction with allergen in contact with nasal mucosa in a sensitized patient. Sensitization to certain airborne allergen, like pollens, dust, molds, animal dander, etc. usually occurs in families with allergy background, which is helpful in making diagnosis in patients who have rhinitis in a certain period of the year, or aggravation of nasal symptoms occurs in the environment typical of certain allergen. The diagnosis is clinically confirmed by proving sensitivity to certain allergen on skin prick test, and by proving specific antibody IgE in patient serum. Allergic rhinitis is categorized according to sensitivity to allergens that occur seasonally, like pollens, or to allergens that are present all year round, like house dust mite, molds and animal dander, into seasonal and perennial allergic rhinitis. Allergy to pollens causes the same mechanism of inflammation in response to allergens, which is the result of allergen binding to specific IgE antibody; however, patients with pollen allergy usually complain more of sneezing and runny nose, whereas patients with allergy to perennial allergens more often complain of obstruction, with the episodes of sneezing and runny nose occurring only when exposed to higher concentrations of allergens (house cleaning, around pets). Treatment includes avoidance of allergens, medical treatment and immunotherapy (allergy vaccines, tablets with allergens). Avoidance of allergens means reduction of environmental allergen load to the respiratory system including workplace, which is not easy to accomplish. Medical treatment is usually necessary to control symptoms, and it includes antihistamines, nasal or in tablets, and nasal glucocorticoids (steroids). Antihistamines should be second generation, which do not cause sedation, and such treatment shows more efficacy on runny nose, sneezing and nasal itch than on nasal stuffiness. Nasal steroids are more potent in improving nasal patency than antihistamines, and are at least as potent in the control of all other nasal and ocular symptoms. Nasal patency may be improved by nasal or oral decongestants, but such treatment should be reduced to as short period as possible, since after several days of using nasal decongestants rebound congestion may occur and patients will need nasal decongestants to improve nasal airways even when allergens are not around anymore.…

PMID: 22359885