Substance Info: (and synonyms)
Penicillium notatum / Penicillium chrysogenum (Mould)

Background Info:

Fungi related to allergies are commonly found in dwelling environments. The predominant fungi Cladosporium, Penicillium, Aspergillus, Alternaria, Wallemia and Rhodotorula live mainly in indoor air, house dust (HD), futons, clothes and contaminated building materials. See Penicillium mould.

Penicillium notatum is very widely distributed in soils, occurring in the temperate zones in forests, grasslands and arable soils with comparable frequencies. It can be isolated from decaying vegetable and leaf litter. It is also found on stored cereals, and hay. The conidia are easily discharged into the air and are counted with high frequency in all aeromycological studies. It is also considered an important in-house mould. Indoors, Penicillium is the blue-green mould found on stale bread, fruits and nuts, and is used for production of green and blue mould cheese. Penicillium has no great seasonal variation but reaches peak concentrations in the winter and spring.


Adverse Reactions:


[ 1 / 13 ]

Salami is a fermented, cured sausage. During the drying and curing phase the skin of the salami is often sprayed with a Penicillium species mold starter to promote flavor and to try to prevent harmful bacteria from multiplying. The type of mold used is different in various production regions. Salami has also been found to contain house dust mites (HDMs) that can occasionally thrive during the curing process. Two case reports: a 5-year-old boy with atopy who developed urticaria and swollen eyelids shortly after eating Salami Tipo Milano, a brand of salami that he had not previously ingested. Second, a 10-year-old boy with atopy and peanut allergy, who developed retrosternal pain and the sensation of food blockage after eating Salametto Milano. He had previously experienced similar feelings after eating raclette cheese. Both children tolerated the foods listed as ingredients. In the first boy, prick-to-prick testing with the salami meat was negative, but testing with the skin of the salami was positive. he manufacturers stated that there was mold in the salami skin which they identified as Penicillium chrysogenum/notatum. Specific IgE to P chrysogenum/notatum was positive at 1.24 kU/L. In the case of the second boy, an endoscopy showed eosinophilic esophagitis. Prick-to-prick testing was negative to salami meat, but positive to the skin of the salami. P chrysogenum/notatum was again present in the salami skin. Specific IgE for P notatum IgE was 12.7 kU/L, Dermatophagoides pteronyssinus 2.32 kU/L, Dermatophagoides farinae 3.02kU/L, Acarus siro 0.4kU/L, and Glycophagus domesticus <0.35 kU/L. The main allergen in P notatum is Pen n 13. It is an alkaline serine protease that shares 39% identical residues with other molds and has been designated in group 13 of the fungal genera.

Sian Ludman, Yannick Perrin, Jean-Christoph Caubet, Jacqueline Wassenberg Perplexing cases of allergy to salami J Allergy Clin Immunol: In Practise 2013;1(1):97-98

[ 2 / 13 ]

Contact dermatitis caused by salami skin. Casings of salami-like sausages are commonly sprayed with Penicillium starter cultures to promote flavour development and to inhibit the growth of undesirable moulds. Occupationally exposed workers may develop respiratory and skin symptoms. A 21-year-old female presented with chronic recurrent dermatitis on the medial aspect of the lower arms, with dry, extremely pruritic papules. Her face and hands were free of lesions. The symptoms became worse in the evening and during the night, and declined at the weekend. On vacations, her dermatitis completely resolved within 1 week. The patient worked in a delicatessen store, cutting and selling sausages. Patch testing was negative for rubber accelerators. Prick testing with a standard series containing common inhalant and food allergens showed positive reactions to dust mites and a weakly positive reaction to Penicillium chrysogenum. ImmunoCAP to Penicillium was positive. Subsequent prick-to-prick testing with the skin of two salami products and crude aqueous extracts prepared from mould layers gave strongly positive results. In western blots, the patient's IgE reacted with several proteins between 30 000 and 90 000 MW in skin extracts from both salami species, but did not bind to a Penicillium oxalicum extract and other moulds. (Wantke 2011 ref.25452 5)

Wantke F, Simon-Nobbe B, Poll V, Gotz M, Jarisch R, Hemmer W. Contact dermatitis caused by salami skin. Contact Dermatitis 2011 Feb;64(2):111-114

[ 3 / 13 ]

Thirty-four adult atopic subjects were randomized into mold-sensitive groups based on skin test reactivity by skin percutaneous testing (SPT) and/or intradermal (ID) testing to a mixed mold (MM) extract preparation (Aspergillus fumigatus, Aspergillus niger, Fusarium oxysporum, Alternaria tenuis, Epicoccum nigrum, Hormodendrum cladosporioides, Pullularia sp., Penicillium notatum, Mucor racemosus, and Trichophyton rubrum). Based on challenge results and scoring model, mold-sensitive subjects compared with nonmold-sensitive subjects experienced cumulatively higher symptom scores after oral challenge to an MM extract preparation. Future studies are warranted to confirm whether ingestion of aeroallergenic molds in food may be another contributor to symptoms in mold-sensitive individuals. (Luccioli 2009 ref.24507 7)

Luccioli S, Malka-Rais J, Nsouli TM, Bellanti JA. Clinical reactivity to ingestion challenge with mixed mold extract may be enhanced in subjects sensitized to molds. Allergy Asthma Proc 2009 Jul;30(4):433-442

[ 4 / 13 ]

IgE Sensitivity to Penicillium chrysogenum Increases with Age. (Bush 2003 ref.8318 3

Bush RK. IgE Sensitivity to Penicillium chrysogenum Increases with Age. Curr Allergy Asthma Rep 2003;3(5):415.

[ 5 / 13 ]

Positive histamine release test, showing serum IgE specific to one or more of the moulds, was observed in 37% of the individuals. The highest frequency of positive histamine release test was found to Penicillium chrysogenum and then to Aspergillus species, Cladosporium sphaerospermum and Stachybotrys chartarum. A significant association was found between most building-related symptoms and positive histamine release test, whereas no association was observed between positive histamine release test to moulds and self reported hay fever or asthma. The study concludes that Positive histamine release test to indoor moulds, showing the presence in serum of IgE specific to the fungi, was found to be related to building-related symptoms in individuals working in damp and mouldy buildings. Whether the association is of causal character is a question for further studies. (Lander 2001 ref.11474 7)

Lander F, Meyer HW, Norn S. Serum IgE specific to indoor moulds, measured by basophil histamine release, is associated with building-related symptoms in damp buildings. Inflamm Res 2001;50(4):227-31

[ 6 / 13 ]

In a Taiwanese study of 1070 patients with asthma, aged from 3 to 70 years, 77.9% were allergic to D. pteronyssinus, 40.0% to German cockroach, 9.6% to P. notatum and 10.4% to C. albicans. For P. notatum, the highest incidence was 18.9% with the age above 61 years. None of them were severe hypersensitivity and 11.9% of them were moderate hypersensitivity. For C. albicans, the highest incidence was 27.3% with the age between 51 and 60 years. All of them were mild hypersensitivity. (Tsai 1999 ref.11475 0)

Tsai JJ, Chen WC. Different age of asthmatic patients affected by different aeroallergens. [Chinese] J Microbiol Immunol Infect 1999;32(4):283-8

[ 7 / 13 ]

Four workers in medical research laboratories, located in a basement level of a University facility equipped with a humidified air conditioning system, complained of cough and/or asthma and/or rhinitis during their normal working activities. Aspergillus fumigatus and Penicillium notatum were found in some laboratories. Eight laboratory workers (including the 4 symptomatic subjects) out of 26 investigated were found to be atopic. Specific IgE sensitisation to Aspergillus fumigatus was found in the 8 atopic and in the 6 non-atopic workers, while Penicililum notatum was found in 7 atopic and 4 non-atopic subjects. The presence of aspergillosis or allergic bronchial aspergillosis in the sensitised subjects was excluded. Our results suggest that evaluation of immune parameters, along with monitoring of the working environment, may reduce the risk of sensitisation and/or allergic symptoms in atopic laboratory workers. (Boscolo 1999 ref.11471 0)

Boscolo P, Piccolomini R, Benvenuti F, Catamo G, Di Gioacchino M. Sensitisation to Aspergillus fumigatus and Penicillium notatum in laboratory workers. Int J Immunopathol Pharmacol 1999;12(1):43-8

[ 8 / 13 ]

In a study of extracts of 14 Penicillium species, Penicillium aurantiogriseum, Penicillium brevicompactum, Penicillium citrinum, Penicillium chrysogenum, Penicillium expansum, Penicillium glabrum, Penicillium hirsutum, Penicillium italicum, Penicillium janthinellum, Penicillium melini, Penicillium oxalicum, Penicillium purpurescens, Penicillium simplicissimum, and Penicillium viridicatum, using pooled human atopic IgE, considerable variation was observed between the Penicillium species with respect to protein yield and the number of distinct protein bands. The most common activities observed among the extracts included acid and alkaline phosphatase, phosphodiamidase and ß-glucosaminidase. The number of discrete atopic IgE-reactive bands in immunoblots of Penicillium extracts ranged from 1 (Penicillium chrysogenum) to 9 (Penicillium viridicatum). Certain allergens showed potential for cross-reactivity between species, including 52 and 54 kDa proteins in Penicillium citrinum, Penicillium purpurescens, Penicillium viridicatum and 40 kDa proteins in several species. The results tend to indicate that Penicillium viridicatum, Penicillium janthinellum, Penicillium oxalicum, Penicillium brevicompactum and Penicillium italicum, which are highly immunogenic as well as allergenic, could possibly be good candidates for allergen cloning studies through the construction of cDNA libraries. (Nguyen 1995 ref.12272 7)

Nguyen MT, Hoffman DR. Anaphylaxis to Laminaria. J Allergy Clin Immunol 1995 Jan;95(1 Pt 1):138-9.

[ 9 / 13 ]

Perennial rhinitis and asthma. (Alonso 1990 ref.5756 6)

Alonso A, Scavini LM, Mouchian K, Rodriguez SM, Iraneta SG. Antigenicity of Penicillium notatum in animals and in atopic patients. Allergol Immunopathol (Madr) 1990;18(6):301-7

[ 10 / 13 ]

In a study of hypersensitivity pneumonitis (humidifier lung) in 9 persons and isolated systemic symptoms without significant changes in lung function and chest x-rays (humidifier fever) in 3 persons, microbiological studies revealed a variety of fungi and bacteria in the water supplies of humidifiers and air conditioners at patients' workplaces. The detection of 4 members of the order Sphaeropsidales (Deuteromycotina), not previously associated with humidifier-induced diseases, is of special interest. Patients demonstrated low concentrations of IgG antibodies against thermophilic Actinomycetes, and other various fungi, such as Alternaria tenuis, Aureobasidium pullulans, Penicillium notatum, Aspergilli, and fungi of the order Sphaeropsidales, which were isolated and cultured from humidifier water supplies. (Baur 1988 ref.11481 7)

Baur X, Behr J, Dewair M, Ehret W, Fruhmann G, Vogelmeier C, Weiss W, Zinkernagel V. Humidifier lung and humidifier fever. Lung 1988;166(2):113-24

[ 11 / 13 ]

Allergic alveolitis caused by P chrysogenum and P cyclopium in a married couple. A careful search of their home revealed a leak in the central heating system with a heavy fungal growth on wet flooring and linoleum. Two species of Penicillium, P chrysogenum and P cyclopium, were isolated from floorboards, linoleum, and settle plates. Antibodies against both these fungi were demonstrated in the serum of both patients by an enzyme linked immunosorbent assay (ELISA). (Fergusson 1984 ref.11484 3)

Fergusson RJ, Milne LJ, Crompton GK. Penicillium allergic alveolitis: faulty installation of central heating. Thorax 1984;39(4):294-8

[ 12 / 13 ]

290 asthmatic patients with positive skin tests for mould allergens were analyzed retrospectively. Tests with Alternaria alternata, Aureobasidium pullulans, Penicillium notatum, Fusarium culmorum, Aspergilus fumigatus and Cladosporium herbarum showed the highest correlation with clinical allergy. (Kersten 1980 ref.11485 7)

Kersten W, Hoek GT. Mould allergy (author's transl). [German] Wien Med Wochenschr 1980;130(8):275-82

[ 13 / 13 ]

Penicillium has long been recognised as one of the moulds most often producing positive skin test reactions in allergic individuals, but it has not been characterised and little is known about the allergen composition. In a study of allergy to Basidiomycetes and Fungi imperfecti, Penicillium scored very high (Lopez 1976 ref.1218 7)

Lopez M, Salvaggio J, et al. Allergenicity and immunogenicity of Basidiomycetes. J Allergy Clin Immunol 1976;57:480-488

Non-Immune reactions

[ 1 ]

Penicillium chrysogenum endophthalmitis. (Galland 2004 ref.11469 3)

Galland F, le Goff L, Conrath J, Ridings B. Penicillium chrysogenum endophthalmitis: a case report. [French] J Fr Ophtalmol 2004;27(3):264-6

[ 2 ]

Penicillium chrysogenum was isolated from three subsequent cerebrospinal fluid (CSF) specimens of a 73-year-old male patient without immunological compromise. (Kantarcioglu 2004 ref.11467 5)

Kantarcioglu AS, Apaydin H, Yucel A, de Hoog GS, Samson RA, Vural M, Ozekmekci S. Central nervous system infection due to Penicillium chrysogenum. Mycoses 2004;47(5-6):242-8

[ 3 ]

In this study, the authors determined the association between serum mold-specific immunoglobulin G (IgG) levels in primary school children (N = 181) with asthma, wheezing, or cough symptoms and exposure to indoor mold in 2 schools, with and without mold damage. There was an association between elevated serum IgG antibody levels to Penicillium notatum and moisture damage in the school. In addition, moisture damage both in school and at home was associated with Penicillium notatum and Eurotium amstelodami IgG levels. The study however, concludes that IgG analysis cannot be readily suggested as a routine method for the evaluation of these exposures. (Hyvarinen 2003 ref.11466 7)

Hyvarinen A, Husman T, Laitinen S, Meklin T, Taskinen T, Korppi M, Nevalainen A. Microbial exposure and mold-specific serum IgG levels among children with respiratory symptoms in 2 school buildings. Arch Environ Health 2003;58(5):275-83

[ 4 ]

Necrotizing pneumonia. (D'Antonio 1997 ref.11477 7)

D'Antonio D, Violante B, Farina C, Sacco R, Angelucci D, Masciulli M, Iacone A, Romano F. Necrotizing pneumonia caused by Penicillium chrysogenum. J Clin Microbiol 1997;35(12):3335-7

[ 5 ]

Fatal necrotizing esophagitis. (Hoffman 1992 ref.11478 5)

Hoffman M, Bash E, Berger SA, Burke M, Yust I. Fatal necrotizing esophagitis due to Penicillium chrysogenum in a patient with acquired immunodeficiency syndrome. Eur J Clin Microbiol Infect Dis 1992;11(12):1158-60


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