Stachybotrys sp.

Description and Natural Habitats

Stachybotrys is a filamentous fungus occasionally isolated as a contaminant from

nature and indoor environments. The geographic distribution of Stachybotrys is
wide. It has been isolated from contaminated grains, tobacco, insulator foams,
indoor air, and water-damaged buildings. Stachybotrys produces trichothecene
mycotoxins known as satratoxins. These toxins may lead to pathological changes
in animal and human tissues [787, 1415].

Species

The genus Stachybotrys has a single well-known species, Stachybotrys

chartarum.

Synonyms

See the summary of synonyms for the Stachybotrys sp.

Pathogenicity and Clinical Significance

Similar to various genera of filamentous fungi, Stachybotrys produces

trichothecene mycotoxins, the satratoxins. Trichothecenes are potent inhibitors of
DNA, RNA, and protein synthesis. They modulate inflammatory reactions and alter
alveolar surfactant phospholipid concentrations. These toxins may be acquired by
ingestion of food products contaminated with the fungus or experimentally, via
direct inhalation of the spores [100, 340, 1116, 1648, 1804, 1805, 2034, 2183,
2266, 2269]. In addition to its mycotoxins, Stachybotrys produces an hemolysin,
stachylysin, which lyses sheep erythrocytes. The existence of the mycotoxin, as
well as the stachylysin, has been demonstrated in some strains [2183, 2319,
2320, 2321].

The pathogenicity of Stachybotrys was first observed in cattle and horses in

Russia in 1920. Stomatitis, rhinitis, conjunctivitis, pancytopenia and neurological
disorders developed in animals following ingestion of hay contaminated with
Stachybotrys. The syndrome was called stachybotrytoxicosis [787, 1046, 1415,
2183]. This outbreak was the first to draw attention to Stachybotrys and its
toxins. Later in the 1970s, it was claimed that Yellow Rain attacks in Southeast
Asia were associated with the use of aerosolized trichothecenes as an agent of
biologic warfare. However, this claim remained scientifically unproven [2069].

Following these, animal studies have been undertaken to demonstrate the

pathogenic effects of the trichothecenes. In one of these investigations, intranasal
administration of trichothecenes to mice was studied. Severe intra-alveolar,
bronchiolar, and interstitial inflammation were observed following the intranasal
exposure [1648]. However, simulation of intranasal exposure by exposing the
mice to extensive surface growth of toxigenic Stachybotrys and high air flow did
not produce these toxic effects, suggesting that the development of toxicosis in
nature following inhalation is unlikely [2435]. This finding also suggested that
mycotoxins of Stachybotrys can be produced or get airborne only under certain
environmental settings [2183].
Stachybotrys has interested health care workers for two reasons. The first is its
possible role in development of sick building syndrome. Stachybotrys is one of the
contaminants inhabiting buildings with major problems in mechanical system
design, construction, and operational strategies, leading to excess indoor
moisture. However, Stachybotrys is only one of the fungal genera isolated in
these buildings and in fact it is less common and in lesser amounts compared to
other mould genera. Aspergillus, Penicillium, Alternaria, and Cladosporium spp.
are more frequently isolated under these settings. Also, the definition and
diagnosis of sick building syndrome is unclear and even more importantly, sick
building syndrome may result from several chemical and physical factors as well
as biological factors, including moulds. These ideas suggest the possibility that
Stachybotrys may play a role in development of sick building syndrome, but most
probably together with other factors [471, 2254].

In a nested case-referent study of adult-onset asthma, domestic exposures to

moulds, environmental tobacco smoke, and the presence of a wood stove were
found to be associated with adult-onset, building-related asthma [2238]. On the
other hand, in three buildings with moisture-damaged interior surfaces where
Stachybotrys chartarum, Aspergillus versicolor, and Penicillium spp. were isolated
and satratoxins were detected, cases with symptoms consistent with potential
asthma and interstitial lung disease were identified [1051]. The presence of IgE
specific to Aspergillus spp., Cladosporium, and Stachybotrys chartarum in serum
was found to be related to the sick building syndrome in another study [1290].

The second reason why Stachybotrys drew attention was its possible role in
development of acute idiopathic pulmonary hemorrhage and hemosiderosis in
infants. In the years 1993 to 1998, several infant cases of acute idiopathic
pulmonary hemorrhage and hemosiderosis were reported. Stachybotrys was
cultivated in their water-damaged houses. The initial cases consisted of 37 infants
living in a limited geographic area in Cleveland, Ohio. Later, reports on additional
cases followed [81, 101, 544, 694, 745, 1561]. Also, Stachybotrys was isolated
from bronchoalveolar lavage fluid of a child with pulmonary hemorrhage [660].
Why did the infants, but not the adults, get the disease? Most authors speculated
that the rapidly growing lungs of the infants were probably more vulnerable to the
pathogenic effects of Stachybotrys toxins. These toxins presumably produced
capillary fragility and eventually precipitated pulmonary hemorrhage in the rapidly
growing lungs [544, 2253].

However, despite all that was reported about the association between acute
idiopathic pulmonary hemorrhage and Stachybotrys, later analysis showed that
the presented data were misleading. No statistically-significant association
between acute idiopathic pulmonary hemosiderosis and Stachybotrys could be
found [97, 102]. In summary, what we know today is limited and speculative and
thus the health risks of environmental exposure to Stachybotrys are unclear. The
actual role of Stachybotrys alone in development of human disease is yet poorly
defined. We don't know whether it is similar or unlike the other mycotoxin-
producing filamentous fungi with respect to its pathogenic potential. Other
mycotoxin-producing moulds which are found to achieve higher indoor
concentrations than Stachybotrys, should be evaluated with respect to their
potential to produce acute idiopathic pulmonary hemorrhage and other
pathologies.

For more detailed information and for sanitation and preservation measures
against indoor Stachybotrys contamination, please see our general discussion of
environmental infestations and our specific discussions of both sick building
syndrome and diseases due to environmental moulds.
Macroscopic Features

Stachybotrys produces cottony, rapidly growing colonies which mature in about 4

days. From both front and reverse, the color of the colony is white initially and
turns to black by aging [1295].

Microscopic Features

Septate hyphae, conidiophores, phialides, and conidia are observed. The hyphae
and the conidiophores appear hyaline initially and become darkly pigmented with
age. The conidiophores which may be simple or branched, bear phialides at their
apices. These phialides are hyaline or pigmented, cylindrical in shape, and have
swollen upper portions. They form clusters of 3 to 10. The conidia (4.5 x 9 µm)
are oval, hyaline or pigmented, 1-celled, and in clusters [1295].

Laboratory Precautions

No special precautions other than general laboratory precautions are required.

Susceptibility

No data are available.

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References

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