Doctors Lounge - Infections Answers
"The information provided on www.doctorslounge.com is designed to support, not replace, the relationship that exists between a patient/site visitor and his/her physician."
Forum Name: Fungal infections
Question: Test For Invasive Mold Infection
|yankeesnmets - Thu Jan 08, 2009 12:15 am|
About 9 months ago I was diagnosed with chronic lyme disease after going to doctor after doctor, with my myriad of symptoms. After being on a rigorous regimen of antibiotics for many months now, I have not gotten much better. My body is still retaining an enormous amount of fluid and I can feel it moving upwards in the body, towards the chest, and I can physically see bubbles of it accumulating.
As a result, I have continued to search my symptoms online, and have found that I have many if not all of the symptoms associated with an invasive mold infection. In my garage I do have an entire wall covered with black mold, which at one time I did try myself to clean up, as well as white mold growing through the floor; this comes as a result of a roof leak, and has been this way for years. Until my recent searches I had not realized the dangers of this mold, and as such have been living in this house in this condition for years. I now have mold growing through the siding as well. I have read that antibiotics can only fix infections, but if the problem is fungal in nature, the problems will persist.
I am having an awful time trying to find a doctor who specializes in diagnosing and treating this type of illness, and my question is what kind of doctor should I be looking for, and more importantly, what kind of tests can be done to diagnose such a problem?
|John Kenyon, CNA - Thu Jan 08, 2009 10:45 pm|
Invasive mold infection and Lyme disease are two of the more frustrating medical problems because of the difficulty in diagnosing in many cases and the fact that they can both share many symptoms. It does sound now as though you may, in fact, have an invasive mold infection, and of course you have an exposure in your history to help bolster that suspicion, so you should be tested. You may need to see an infectious disease specialist, and doctors at the National Institutes of Health have developed a fairly specific test for this, a quantitative real-time PCR assay to detect the 5.8S ribosomal RNA gene of Aspergillus and other molds in the blood. I would strongly suggest you request both a referral to an infectious disease specialist and that you note the name of the PCR essay test to request specifically (it may well be a send-out test, depending on where you live). This should help make the differential diagnosis between Lyme and invasive mold.
I hope this is helpful to you. Best of luck and please do follow up with us as needed.
|Dr. Tamer Fouad - Fri Jan 09, 2009 3:26 am|
I wanted to add to John's excellent response that invasive aspergillosis usually does not occur unless the person has severe immunosuppression. This includes advanced stages of AIDS, prolonged and severe neutropenia, glucocorticoid therapy, transplantation, and granulomatous diseases. Mold infection can affect a person with normal immunity but the infection and the symptoms are mild and the infection is not of the invasive variety.
A test that is commonly used in the diagnosis of invasive aspergillosis is called Galactomannan. This may precede appearance invasive aspergillosis by CT scan.
Galactomannan used in combination with the PCR test which John alluded to has been reported to have a superior sensitivity and specificity in the diagnosis of this disease.
Again, as John has expertly suggested, an infectious disease specialist is the one you want. How was Lyme disease diagnosed? What tests were used and what were the results?
Oh and you obviously need to find a way to get rid of that mold exposure!
|yankeesnmets - Mon Feb 02, 2009 12:32 am|
Thank you both for your thorough responses.
I have recently been to a see a couple of doctors, at what are considered to be some of New York City's top hospitals, and they have told me that they are unable to do a Galactomannan test with PCR. Do you have any knowledge of a lab in the U.S that is capable of doing such a test? The seem to know nothing about it here in New York. I was only given a Galactomannan test and was told that the results will be back in a week. However, I worry that this test is not enough and that what I really need is the PCR or the PCR in combination with the Galactomannan.
Thank You For All of Your Help!
|Dr. Tamer Fouad - Tue Feb 03, 2009 4:33 am|
Thank you for your question. The PCR test which John alluded to is not a commercial test which is why he mentions the possibility of a send out to the NIH. It has shown increased sensitivity and specificity when used in combination with the Galactomannan test (ELISA).
I personally think you should wait for your Galactomannan results first.
Keep us updated!
|| Check a doctor's response to similar questions|
Are you a Doctor, Pharmacist, PA or a Nurse?
Join the Doctors Lounge online medical community
Editorial activities: Publish, peer review, edit online articles.
Ask a Doctor Teams: Respond to patient questions and discuss challenging presentations with other members.