Update on airborne mold and mold allergy.

In considering the clinical aspects of fungal sensitivity, assessing exposure potential and clinical testing are essential. Valid prevalence data are difficult to secure. For ambient air, the Burkard Volumetric Spore Traps, or equal, capture spores best. For in-home analysis for fungi, the history and personal inspection of the house remains the most available method of assessment. Allergy skin test material is unavailable for most airborne fungi. Those that are available are not standardized. Yet the practicing allergist/clinical immunologist must select what fungal extract are available based on air sampling data and personal exposure of the patient. A major management approach with patients with proven sensitivity to fungal antigens and a clear correlation with clinical illness is avoidance of fungal sources. Immunotherapy should be considered when avoidance and well tolerated pharmacotherapy are ineffective in controlling the patient's symptoms.