Research
Intranasal Nystatin Therapy in Patients with Chronic Illness Associated with Mold and Mycotoxins
We have previously reported that patients with chronic illness frequently had a history of prior exposure to water damaged buildings (WDB) and mold. These patients were found to have elevated levels of mycotoxins in the urine. We postulated that the mycotoxin producing molds colonize the sinuses of these patients and lead to chronic symptoms. In a recent observational analysis of patients treated with intranasal antifungal agents, either amphotericin B (AMB) or itraconazole (ITR), we showed that 94% of these patients improved clinically (AMB group). We also found that the urine mycotoxin levels decreased substantially in patients that improved on therapy. However, AMB was associated with local (nasal irritation) adverse effects (AE) in 34% of the cases, which resulted in discontinuation of therapy. The present study expands these treatment observations in which patients intolerant to AMB were treated with intranasal nystatin (NYS). We found very promising improvements with this agent as well. No local (nasal) AE were seen with NYS.
Intranasal Antifungal Therapy in Patients with Chronic Illness Associated with Mold and Mycotoxins: An Observational Analysis
Exposure to mycotoxin producing mold and mycotoxins can be associated with numerous adverse health consequences. We previously reported that patients with chronic illness frequently had a history of prior exposure to water damaged buildings (WDB) and mold. Additionally, the vast majority of these patients had mycotoxins present in the urine. We have postulated that the mycotoxin producing molds were likely harbored internally in the sinuses of these patients. In the present analysis, patients with chronic illness and a positive urine mycotoxin assay were treated with intranasal antifungal therapy, either amphotericin B (AMB) or itraconazole (ITR). AMB was associated with local (nasal) irritation adverse effects (AE) in 34% of the cases, which resulted in discontinuation. In patients that remained on therapy without AE, we found that 94% improved clinically. Additionally, we found that the urine mycotoxin levels decreased substantially in patients that improved on therapy. Similar findings were seen with ITR, however the number of patients treated was much smaller.
