Fungi and the microbiome finally got on my radar. Apologies to some, but there is a lot of different items on the microbiome radar screen.

“Small intestinal fungal overgrowth (SIFO)… Two recent studies showed that 26 % (24/94) and 25.3 % (38/150) of a series of patients with unexplained GI symptoms had SIFO. …. but evidence for eradication is lacking.”Small intestinal fungal overgrowth [2015]

As I did with taxa years ago, I will be writing a blog on each one reviewing the literature. If there is sufficient data at the end, I may add it as a feature to Microbiome Prescription.

• CDC provides a list of known fungal diseases: Types of Fungal Diseases.
• For the current list of Fungi reviewed on this list, click Information of Different Types Of Fungi

One of my reader’s results motivated this choice. The data from a Thorne Microbiome Test. Almost 9 out of 10 people have less of it. The person also has a Crohn’s diagnosis.

Preventive for Fungi

The following are suggestions:

• Reduce and keep your living space humidity at 50% or lower (typically done by dehumidifiers). EPA recommends 30-50% [EPA]; we set our dehumidifiers for 35%.

Moisture parameters and fungal communities associated with gypsum drywall in buildings [2015]

• Use a HEPA filter appropriate to your space.
  Effectiveness of Airborne Fungi Removal by using a HEPA Air Purifier Fan in Houses [2018]
  Typically they are described as “Room Size: Up to 1500 sq.ft. maximum”. We are more aggressive and divide that by 4. For example we use 3 Austin Air HealthMate HEPA Air Purifier for our 900 sq.ft. living space.
• Check the north side of your building for mold. If found pressure wash it off and if possible, apply substances to inhibit them coming back.
• Check for mushrooms in lawns etc. If found, remove them and treat where you found them.

Remember, all fungi are not the same. Antibacterial and Antifungal Activities of Spices [2017] does not mention this fungi. Additionally, some spices are known to have Fungal Contamination of some Common Spices [2022] and Fungi and aflatoxins associated with spices in the Sultanate of Oman [2002] which included cloves (often deem an antifungal).

Basic Information

Image from [Mycology]

It is sometime identified as  black yeast fungus.

• Not listed on CDC list, Types of Fungal Diseases
• Exophiala – an overview | ScienceDirect Topics – “is an agent of olecranon bursitis²² and central nervous system disease”
• The Black Yeast Exophiala dermatitidis and Other Selected Opportunistic Human Fungal Pathogens Spread from Dishwashers to Kitchens [2016]
  • “The black yeast E. dermatitidis was detected in 47% of the dishwashers, primarily at the dishwasher rubber seals, at up to 10⁶ CFU/cm²“
  • “Eighteen percent of all of the washed items were contaminated with fungi, irrespective of the type of material they were made from.”
• “Exophiala species are common environmental fungi often associated with decaying wood and soil enriched with organic wastes….Phaeohyphomycosis caused by Exophiala species has been reported in both normal and immunosuppressed patients.” [Mycology]
• Cerebral Phaeohyphomycosis Caused by Exophiala dermatitidis in a Chinese CARD9-Deficient Patient: A Case Report and Literature Review [2019]
• Disseminated Exophiala dermatitidis causing septic arthritis and osteomyelitis [2018]
• E. dermatitidis is, among other species, a common colonizer of the respiratory tract of patients with CF [2018]
• “predisposing factors for E. dermatitidis infections are diabetes mellitus, steroid medication, concurrent bacterial and fungal infections and nutritional deficiencies” [2018]
• “Immunosuppressed and elderly patients suffer from infections with E. dermatitidis most commonly in the form of phaeohyphomycosis, keratitis or chromoblastomycosis;”[2018]
• “Fatal brain infections caused by the neurotropic E. dermatitidis occurred in otherwise healthy individuals in the Asian population” [2018]

Treatment

• Exophiala dermatitidis: Key issues of an opportunistic fungal pathogen [2018] list these as effective
  • amphotericin B ,
  • 5-fluorcytosine,
  • itraconazole,
  • fluconazole,
  • voriconazole
  • posaconazole (best)

Cleaning Dishwashers etc

The conventional advice is to use vinegar,baking soda or bleach. Studies indicate that it tolerates a very wide variety of pH (Roles of the pH signaling transcription factor PacC in Wangiella (Exophiala) dermatitidis [2009] ), i.e. pH 2.5 to pH 8 with most effective to inhibit being pH 2.5 (where Vinegar is). Bleach is pH 11-13, so likely also effective.

Since this often is black in appearance, sinks and other places should be regularly checked for any black discoloring which could indicate mold..

Bottom Line

This attempts to summarize the current information on Exophiala.