How do you or your practice manage young, average-risk patients without structural lung disease referred to you or self-referred for concern of environmental mold exposure?

These individuals are generally managed by pulmonology and allergy/immunology clinics because the clinical presentation is generally more aligned with allergy-type symptoms like a chronic cough, congestion, or other symptoms associated with airway irritation. In individuals who are receiving chronic long-term steroids or are on immunosuppressive therapies, persistent symptoms and imaging findings consistent with atypical infection kill GGOs or dense patchy opacities, could signal a true infectio...

“Exposure” does not equal disease or infection. Exposure = exposure, no more, no less. Even for the most immunocompromised (BMT in our experience), we warn them to avoid exposure to the degree possible and probe carefully for signs and symptoms of disease, but nothing more. Of course, should even subtle evidence of bronchoallergic or invasive disease be uncovered, we immediately and rigorously initiate serologic, molecular, and radiographic testing as well as presumptive treatment, but this is u...