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Rationale Most reactions to indoor mold exposure have been reported from mold-contaminated homes, office buildings or schools. We report a patient who experienced symptoms from exposure to a contaminated air-conditioner in her automobile. Methods A patient with a two-year history of generalized symptoms that continued despite taking two months off of work was skin tested and administered the Rhinitis Outcome Questionnaire (ROQ) and Cognitive Questionnaire (CQ) to assess her symptoms. Her indoor environments were also tested for mold contamination. Her home was tested using the Allergenco MK-3 Sampler for which we consider normal indoor counts below 1000 spores/M 3 . The mold counts in the patient's car were tested using an Anderson Sampler for which we consider normal counts less than 200 CFU/M 3 . Results The patient had positive ID testing to Alternaria, Aspergillus, Penicillium and Cladosporium. The indoor mold counts in her home did not indicate indoor mold growth. The ROQ and CQ both gave similar results, showing low, non-allergic symptom scores before exposure, then moderate to severe symptoms at the height of exposure and a return to baseline upon avoidance of exposure. The result of testing her car with the ventilation system running was high: 1,740 CFU/M 3 , Penicillium (42%) and Aspergillus (58%). Avoidance of the car brought about a marked improvement in symptoms and she was able to return to work. Conclusions This case demonstrates that we should be testing work environments, homes and schools for mold contamination and must now add automobiles to our testing regimen where indicated. |
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