Intranasal Nystatin Therapy in Patients with Chronic Illness Associated with Mold and Mycotoxins

1
Joseph Brewer
Joseph Brewer
2
Joseph H. Brewer
Joseph H. Brewer
3
Dennis Hooper
Dennis Hooper
4
Shalini Muralidhar
Shalini Muralidhar
1 St. Lukes Hospital, Kansas City, Missouri

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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.

Funding

No external funding was declared for this work.

Conflict of Interest

The authors declare no conflict of interest.

Ethical Approval

No ethics committee approval was required for this article type.

Data Availability

Not applicable for this article.

Joseph Brewer. 2015. \u201cIntranasal Nystatin Therapy in Patients with Chronic Illness Associated with Mold and Mycotoxins\u201d. Global Journal of Medical Research - K: Interdisciplinary GJMR-K Volume 15 (GJMR Volume 15 Issue K5): .

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Crossref Journal DOI 10.17406/gjmra

Print ISSN 0975-5888

e-ISSN 2249-4618

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GJMR-K Classification: NLMC Code: QW 630.5.M9
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v1.2

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December 29, 2015

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English

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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.

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Intranasal Nystatin Therapy in Patients with Chronic Illness Associated with Mold and Mycotoxins

Joseph H. Brewer
Joseph H. Brewer
Dennis Hooper
Dennis Hooper
Shalini Muralidhar
Shalini Muralidhar

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