• Julia Hurraß, Dennis Nowak, Birger Heinzow, Marcus Joest, Jannik Stemler, and Gerhard A Wiesmüller.
• Hygiene in healthcare facilities, Department of Infection and environmental hygiene, Health Department of Cologne, Germany; Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Member of German Center for Lung Research (DZL), Comprehensive Pneumology Center (CPC München), Clinical Center of the Ludwig Maximilian University Munich, LMU Munich, Germany; Formerly: State Office for Social Services (LAsD) Schleswig-Holstein, Kiel, Germany; Helios Lung and Allergy Centre Bonn, Allergological-immunological laboratory, Germany; Institute for Translational Research, CECAD Cluster of Excellence, University of Cologne, Germany; Department I of Internal Medicine, University of Cologne, European Excellence Center for Invasive Fungal Infections (ECMM), Germany; Institute for Occupational, Social and Environmental Medicine, University Hospital RWTH Aachen, Germany; Laboratory Dr. Wisplinghoff; ZfMK - Center for Environment, Hygiene and Mycology, Cologne, Germany.
• Dtsch Arztebl Int. 2024 Apr 19; 121 (8): 265271265-271.

BackgroundAccording to self-reported frequencies, every fifth or sixth dwelling in Germany is affected by dampness and/or mold. This carries a potential risk to health.MethodsThis review is based on pertinent publications retrieved by a selective literature search and inquiry in the GENESIS database, on the AWMF guideline on the medical clinical diagnosis of indoor mold exposure, as updated in 2023, and on the relevant contents of other current guidelines. Based on this research, we present an algorithm for the evaluation of health problems that may be due to mold in indoor environments.ResultsA rational diagnostic work-up begins with history-taking and physical examination, with attention to risk factors-above all, immune compromise and atopy. If there is evidence of atopy, targeted allergy diagnostics should be performed, consisting of a skin prick test and/or measurement of specific IgE antibodies, supplemented whenever indicated by provocative testing and cellular test systems. If the patient's immune response is compromised, the immediate cessation of mold exposure has absolute priority. Any suspected invasive fungal infection should be evaluated with radiological, microbiological, serological, and immunological testing. Indoor measurements of mold fungi, microbial volatile organic compounds (MVOC), and/or mycotoxins are generally not indicated as part of the medical evaluation; nor are blood or urine tests for particular mold components or metabolites.ConclusionMold in indoor environments should be dealt with by rapid exposure elimination for patients at risk, the rational diagnostic evaluation of any symptoms and signs of disease, and patient education about the possibilities and limitations of diagnostic testing and the generally limited utility of measurements in the affected interior spaces.

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