From the Guidelines
Black mold lung infections, known as pulmonary aspergillosis, are serious fungal infections typically caused by Aspergillus species, and treatment usually involves antifungal medications like voriconazole (typically 6mg/kg IV twice daily for 1 day, then 4mg/kg twice daily) or amphotericin B (1-1.5mg/kg/day IV) for severe cases, as recommended by the Infectious Diseases Society of America 1.
Key Considerations
- The infection occurs when mold spores are inhaled and grow in the lungs, with severity ranging from allergic reactions to life-threatening invasive disease.
- Patients should seek immediate medical attention if experiencing persistent cough, shortness of breath, chest pain, or coughing up blood.
- Those with weakened immune systems, lung diseases, or who have undergone organ transplants are at higher risk.
Treatment Options
- For invasive infections, treatment typically continues for at least 6-12 weeks, while chronic forms may require longer therapy.
- Voriconazole is the primary treatment option for invasive pulmonary aspergillosis, with a recommended dose of 6mg/kg IV twice daily for 1 day, followed by 4mg/kg twice daily, as stated in the 2016 update by the Infectious Diseases Society of America 1.
- Alternative treatment options include liposomal amphotericin B, isavuconazole, and posaconazole.
Prevention
- Prevention includes avoiding moldy environments, wearing masks during activities that disturb soil or dust, and maintaining good indoor air quality with proper ventilation and humidity control.
- The 2018 ESCMID-ECMM-ERS guideline recommends itraconazole or voriconazole as effective treatment options for chronic cavitary pulmonary aspergillosis, with a minimum treatment duration of 6 months 1.
From the FDA Drug Label
Voriconazole, administered orally or parenterally, has been evaluated as primary or salvage therapy in 520 patients aged 12 years and older with infections caused by Aspergillus spp., Fusarium spp., and Scedosporium spp.
The FDA drug label does not mention black mould as a specific type of fungal lung infection. However, it does discuss the treatment of infections caused by Aspergillus spp., which can cause fungal lung infections.
- The drug label mentions that Voriconazole was effective in treating invasive aspergillosis (IA), with a satisfactory global response rate of 53% compared to 32% for amphotericin B.
- The label also mentions that Voriconazole was effective in treating patients with Aspergillus fumigatus infections, with a success rate of 59%. However, since black mould is not specifically mentioned, no conclusion can be drawn about the effectiveness of Voriconazole for this particular type of infection 2.
From the Research
Fungal Lung Infection Black Mould
- Fungal lung infections, including those caused by black mould, are a challenge to diagnose and treat 3.
- Black mould is a type of dematiaceous mould that can cause pulmonary infections, particularly in immunocompromised patients 3, 4.
- Treatment options for fungal lung infections include antifungal combination therapy, which has emerged as a promising strategy 3.
- Antifungal agents such as voriconazole, itraconazole, and posaconazole may be used to treat fungal lung infections, including those caused by black mould 5, 6, 7.
- The choice of antifungal agent depends on the specific type of infection, the patient's underlying health conditions, and the potential for drug interactions and hepatotoxicity 5, 6.
- Combination therapy with multiple antifungal agents may be considered in certain cases, but its use is still being explored and requires careful consideration of potential interactions and adverse effects 3, 7.