Q:

2/26/2013
My current mold panel include Aspergillus, Epicoccum, Helminthosporium, cladosporium, penicillium, Alternaria. Would you add anymore?

A:

Thank you for your inquiry.

We have dealt with this issue a number of times on our website. I have copied for you below the gist of an answer supplied by Dr. Robert Bush, who is a nationally known expert in mold allergy. There is additional information in other entries on our website. You can access these by going to the “Ask the Expert” website and typing “molds” into the search box.

Thank you again for your inquiry and we hope this response is helpful to you.

Answer supplied by Dr. Robert Bush:
"I think the consensus for a basic fungal allergen panel would be:

1. Alternaria alternata

2. Cladosporium cladosporoides/sphaerospermum. Cladosporium herbarum should be tested, if available, since it is common in air samples.

3. Penicillium chrysogenum (notatum). One could see if P expansum is in any mix or alone. If so, I would use it or a Pen mix in the expanded panel.

4.Drechslera/Curvularia or Helminthosporium/Bipolaris. One could use the Helminthosporium in the basic and the Drechslera/Curvularia in the expanded panel

5. Epicoccum nigrum

6. Aspergillus fumigatus

For the expanded panel. Keep in mind the poor quality of fungal extracts and cross-reactivity.

1. Aspergillus mix (hopefully, one with A flavus since it is common in indoor settings)

2. Penicillium mix or P. expansum, if available. I'm not sure why P.expansum is on the parameters list.

3. Fusarium roseum

4. Auerbasidium pullulans

5. Chaetonium globosum

6. Mucor species/Rhizopus species (often cross-reactive).

7. Trichophyton tonsurans was the species Dr Platts-Mills identified as being associated with asthma in nail infections. I haven't heard anything on this area for years. It's probably not worth testing .C.albicans has been implicated in some cases of an ABPA -like syndrome. I'm not sure what to make of a positive test."

Sincerely,
Phil Lieberman, M.D.

AAAAI - American Academy of Allergy Asthma & Immunology