Abstract

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