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Boiko NV, Gurov AV, Stagnieva IV, Bannikov SA. [Peculiarities of fungal and bacterial microorganisms persistence in the structure of fungal balls of paranasal sinuses]. Vestn Otorinolaringol 2023; 88:34-37. [PMID: 37450388 DOI: 10.17116/otorino20228803134] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
OBJECTIVE To compare the data of pathomorphological and microbiological examination of fungal balls removed at paranasal sinuses endoscopic surgery. MATERIAL AND METHODS A total of 148 samples were obtained from patients histologically diagnosed with fungal balls. Microscopic evaluation of the specimens stained according to the Gram method, Gomori-Grocott method and PAS-reaction method, revealed phase changes in the fungal balls conditioned by their different life cycles: the areas of young, mature and degenerating mycelium were detected. Degeneration lead to detritus formation. Detritus areas contained accumulated bacterial colonies. The cultural study of the fungal balls removed from paranasal sinuses, showed fungi growth in 17.6% of cases, while the pathomorphological study confirmed presence of fungi in every investigated sample. Aerobic and anaerobic microbiota of the sinuses contents was represented by multi-agent bacterial and fungal-bacterial associations. Statistical analysis of contingency between culture-positive rate of fungi and different bacteria detected in clinical samples from fungal balls revealed inhibitory influence of Pseudomonas aeruginosa on fungi growth, which might be a reasons of their low isolation rate. Supposedly in some cases the fungal balls consisted of dead fungi, or the sampling was done in the area of the fungal balls degeneration, which might also account for the low sensibility of the cultural method.
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Affiliation(s)
- N V Boiko
- Rostov State Medical University, Rostov-on-Don, Russia
| | - A V Gurov
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - I V Stagnieva
- Rostov State Medical University, Rostov-on-Don, Russia
| | - S A Bannikov
- Regional Consultative and Diagnostic Center, Rostov-on-Don, Russia
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Microbiological and Radiological Perspective of Fungal Rhinosinusitis during the COVID-19 Pandemic: A Prospective Observational Study in A Tertiary Care Centre in Northern India. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2021. [DOI: 10.22207/jpam.15.4.70] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Radiological investigations are essential for the diagnosis and classification of fungal rhinosinusitis; however, radiological findings might occasionally be misleading. Computed tomography (CT) scan and magnetic resonance imaging (MRI) complement each other, facilitating clinicians to arrive at a diagnosis. Hence, even with the best radiological modalities, correlation between clinical and microbiological findings is crucial for the accurate diagnosis of fungal rhinosinusitis. In addition, the role of traditional methods such as KOH microscopy and culture should be accurately evaluated. To this end, we aimed to diagnose rhinosinusitis with a fungal etiology based on radiological findings and subsequently correlate these findings with those of microbiological techniques, namely culture and KOH microscopy. A total of 57 clinically suspected fungal rhinosinusitis cases were included in the study. Radiological investigations were performed using either CT or MRI. Tissues samples were processed and analyzed using KOH microscopy and culture. The results of the study suggest that using a single method for the diagnosis of fungal rhinosinusitis is inadequate. Rather, the diagnosis should be based on radiological as well as microbiological findings, especially for cases that are clinically ambiguous.
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Kawaji-Kanayama Y, Nishimura A, Yasuda M, Sakiyama E, Shimura Y, Tsukamoto T, Kobayashi T, Mizutani S, Okamoto S, Ohmura G, Hirano S, Konishi E, Shibuya K, Kuroda J. Chronic Invasive Fungal Rhinosinusitis with Atypical Clinical Presentation in an Immunocompromised Patient. Infect Drug Resist 2020; 13:3225-3232. [PMID: 32982337 PMCID: PMC7509339 DOI: 10.2147/idr.s273317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 08/25/2020] [Indexed: 01/23/2023] Open
Abstract
Invasive fungal rhinosinusitis (FRS) is a rare but intractable infectious disease of the sinonasal region with destructive direct infiltration into surrounding tissues, such as the bone, orbit and brain, and potential dissemination to systemic organs. Symptomatic assessments and imaging are frequently not sufficiently diagnostic, and histopathological examination is essential for definite diagnosis of FRS. We herein report a case of chronic invasive FRS (CIFRS) in a 58-year-old Japanese male with end-stage diabetic nephropathy that required maintenance dialysis after graft rejection of living kidney transplantation. His initial main clinical presentation was sinus gangrene, which gradually progressed from the paranasal sinus to the nasal septum and oral palate, but not towards the intracranial or orbital region, for two months. The patient was first strongly suspected to have extranodal natural killer/T cell lymphoma (ENKTL), nasal type, a subtype of malignant lymphoma, based on the macroscopic appearance of the gangrene, expansion pattern and high serum soluble interleukin-2 level; however, repeated biopsies and eventual resection led to diagnosis of CIFRS due to Aspergillus niger and Mucor. The disease was improved by surgical resection in combination with antifungal pharmacologic treatment with liposomal amphotericin B and voriconazole. CIFRS typically occurs in immunocompetent patients and shows intracranial progression, but this case shows that atypical CIFRS with an uncommon expansion pattern can occur in an immunodeficient patient.
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Affiliation(s)
- Yuka Kawaji-Kanayama
- Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Ayako Nishimura
- Division of Surgical Pathology, Department of Pathology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Makoto Yasuda
- Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Emiko Sakiyama
- Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
- Department of Hematology, Matsushita Memorial Hospital, Moriguchi, Japan
| | - Yuji Shimura
- Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Taku Tsukamoto
- Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tsutomu Kobayashi
- Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Shinsuke Mizutani
- Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Shota Okamoto
- Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Gaku Ohmura
- Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Shigeru Hirano
- Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Eiichi Konishi
- Division of Surgical Pathology, Department of Pathology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kazutoshi Shibuya
- Department of Surgical Pathology, Toho University Graduate School of Medicine, Tokyo, Japan
| | - Junya Kuroda
- Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Liu X, Liu C, Wei H, He S, Dong S, Zhou B, Zhang L, Li Y. A retrospective analysis of 1,717 paranasal sinus fungus ball cases from 2008 to 2017. Laryngoscope 2019; 130:75-79. [PMID: 31466130 DOI: 10.1002/lary.27869] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 01/20/2019] [Accepted: 01/28/2019] [Indexed: 11/10/2022]
Affiliation(s)
- Xin Liu
- Department of Otolaryngology–Head and Neck SurgeryBeijing Tongren Hospital, Capital Medical University Beijing China
| | - Chengyao Liu
- Department of Otolaryngology–Head and Neck SurgeryBeijing Tongren Hospital, Capital Medical University Beijing China
| | - Hongzheng Wei
- Department of Otolaryngology–Head and Neck SurgeryBeijing Tongren Hospital, Capital Medical University Beijing China
| | - Shuai He
- Department of Otolaryngology–Head and Neck SurgeryBeijing Tongren Hospital, Capital Medical University Beijing China
| | - Shouxiang Dong
- Department of Otolaryngology–Head and Neck SurgeryBeijing Tongren Hospital, Capital Medical University Beijing China
| | - Bing Zhou
- Department of Otolaryngology–Head and Neck SurgeryBeijing Tongren Hospital, Capital Medical University Beijing China
| | - Luo Zhang
- Department of Otolaryngology–Head and Neck SurgeryBeijing Tongren Hospital, Capital Medical University Beijing China
- Beijing Key Laboratory of Nasal DiseasesBeijing Institute of Otolaryngology Beijing China
| | - Yunchuan Li
- Department of Otolaryngology–Head and Neck SurgeryBeijing Tongren Hospital, Capital Medical University Beijing China
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