From the Guidelines
Treatment for Cladosporium herbarum exposure typically involves addressing the allergic symptoms it causes rather than treating the mold itself. For mild allergic reactions, over-the-counter antihistamines like cetirizine (10mg daily), loratadine (10mg daily), or fexofenadine (180mg daily) can provide relief 1. Nasal symptoms may respond to intranasal corticosteroids such as fluticasone (1-2 sprays per nostril daily) or mometasone (2 sprays per nostril daily). For asthmatic symptoms triggered by the mold, bronchodilators like albuterol (2 puffs every 4-6 hours as needed) and inhaled corticosteroids such as fluticasone (2 puffs twice daily) may be necessary. In severe cases, oral corticosteroids like prednisone (typically 40-60mg daily for 5-7 days, tapering as directed) might be prescribed. The most important step is removing the source of exposure by addressing moisture problems and cleaning mold-affected areas with appropriate fungicides, as suggested by studies on environmental allergen avoidance 1. For immunocompromised individuals, exposure can be more serious, potentially requiring antifungal medications. Cladosporium herbarum is one of the most common outdoor and indoor molds and produces allergens that can trigger IgE-mediated allergic responses in susceptible individuals, particularly affecting the respiratory system. Allergen immunotherapy with fungi might be effective, but the allergen content of most mold extracts is highly variable 1. Key measures to reduce exposure include:
- Preventing spore infiltration by closing doors, windows, and using air conditioning
- Controlling moisture by means of dehumidification, sealing water leaks, and using dehumidifiers
- Cleaning and removing contaminated materials by applying fungicides
- Using high-efficiency air filters
- Maintaining heating ventilation and air-conditioning systems
- Using personal protective equipment, such as particle masks, when involved in cleaning contaminated materials.
From the Research
Treatment for Cladosporium herbarum Exposure
The treatment for Cladosporium herbarum exposure includes:
- Immunotherapy with Cladosporium herbarum extract, which has been shown to be effective in reducing symptoms and medication consumption in patients with Cladosporium allergy 2, 3, 4
- The use of a purified and standardized Cladosporium herbarum preparation has been found to be effective in children with mould-induced asthma and/or rhinoconjunctivitis 4
- Immunotherapy with Cladosporium herbarum has been found to reduce bronchial and conjunctival sensitivity in patients with Cladosporium allergy 2, 4
Considerations for Treatment
- Immunotherapy with Cladosporium herbarum can cause side effects, such as large local reactions and episodes of asthma, especially during the peak of the mould season 2, 4
- The use of immunotherapy with Cladosporium herbarum should be limited to highly specialized clinics and should only be considered for patients with demonstrated exposure to Cladosporium herbarum and symptoms that correlate with that exposure 3
- The identification of specific allergens, such as translationally controlled tumor protein (TCTP) and a novel allergen structurally homologous to the alpha/beta hydrolase fold superfamily, may be useful in the development of more targeted treatments for Cladosporium herbarum allergy 5, 6