The health of a family of six residing in a water-damaged home is presented. The family consisted of the parents (age 29) two boys (ages 8 and 12) and new born fraternal twins (male and female. The parents and two boys developed RADS/asthma and had multiple symptoms including nose bleeds.The fraternal twins experienced respiratory illness that required hospital treatments. The infant girl survived while her brother was found face down, blue in color, lifeless with oral and nasal blood discharge. Pathology demonstrated areasof peribronchial inflammation, intra-alveolar, and numerous hemosiderin laden macrophage (hemosiderosis). Environmental evaluation of the home revealed Stachybotrys, Aspergillus/Penicillium, Cladosporium and Chaetomium in various rooms of the home. Mycotoxins detected in the home included Sterigmatocystin, 5 methoxy-sterigmatocystin Roquefortine C, Satratoxin G and H, Roridin E and L-2, isosatratoxin Fas well as other Stachybotrys secondary metabolites. Aspergillus versicolor was identified by PCR-DNA analysis in the lungs and brain of the deceased child. Aflatoxin was detected in his lungs, while monocyclic trichothecenes were identified in the lungs, liver and brain. The literature is briefly reviewed on the subject of fungi and their secondary metabolites present in water-damaged homes and buildings.