How is mold-related extrinsic allergic alveolitis (EAA) staged?

Updated: Sep 18, 2017
  • Author: Shih-Wen Huang, MD; Chief Editor: Harumi Jyonouchi, MD  more...
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Answer

The acute form is easily recognized because symptoms are quickly distressing and incapacitating and have a high degree of specificity. Patients have repeated episodes of an influenza-like illness accompanied by coughing and undue breathlessness 3-9 hours after exposure to the offending fungi. The sensitizing period may vary from weeks to years. Affected patients may soon be able to identify the causative environment. The exposure level determines the severity of the disease.

In the chronic form, a slowly increasing loss of exercise tolerance occurs because of shortness of breath. This is the result of diffuse pulmonary fibrosis, which has been progressing for years. Eventually, hypoxia and pulmonary hypertension may supervene, and the right heart fails.

Depending on the level of fungal Ags exposed and the host responses, various intermediate forms of EAA can be recognized. Therefore, acute exacerbation may occur in those with a chronic form of the disease with only a limited degree of recovery following cessation of exposure. However, in some cases, fibrotic damage continues, regardless of the cessation of exposure.


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