Diseases caused by mycotoxins are called mycotoxicoses. Trichothecene mycotoxins are low-molecular-weight compounds produced by more than 350 species of fungi and are pathogenic to animals and humans. The T-2 mycotoxin is the most extensively studied of the trichothecenes and is the only mycotoxin known to have been used as a biological weapon. Mycotoxins such as trichothecene are potential biological weapon agents because they can be absorbed through intact skin and cause systemic toxicity. Mycotoxins can be delivered by food or water sources as well as via droplets, aerosols, or smoke from dispersal systems and exploding munitions.
Mycotoxicoses occur when mycotoxins enter the body, usually by ingestion. Different mycotoxins cause different diseases. Trichothecene mycotoxins are very cytotoxic and potentially immunosuppressive. Mycotoxins can be absorbed by topical, oral, and inhalational routes and can act as a dermal irritant and blistering agent. Local or systemic toxicity can result from any route of exposure (dermal, oral, or inhalational), depending on the mycotoxin.
Complications may include vascular collapse, desquamation and necrosis of dermal layers, severe dizziness, ataxia, and prostration.
Patients with cutaneous symptoms may report seeing clouds of a yellow-colored smoke or aerosol, but blue and green aerosols have also been reported. Yellow droplets may be present on clothing, and affected individuals may experience immediate pain and burning on exposed skin surfaces and in the eyes. Redness, rash, and blistering may be present; other symptoms of mycotoxin exposure may include vomiting, diarrhea, dyspnea, and bleeding. With virulent toxins such as trichothecene, some symptoms may appear within seconds of exposure while others develop over hours, days, or longer.
With systemic exposure, trichothecene mycotoxicoses produce more severe symptoms such as mild ataxia. Ocular exposure causes tearing, pain, conjunctivitis, and blurred vision. Nasal mucosa exposure results in sinus irritation, pain, rhinorrhea, sneezing, and potentially epistaxis. Oral and oropharyngeal exposure produces pain and blood-tinged saliva and sputum. Pulmonary symptoms include cough, dyspnea, and wheezing. Other symptoms include tachycardia, nausea, vomiting, anorexia, watery diarrhea, and abdominal cramping.