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Allergic fungal rhinosinusitis: detection of fungal DNA in sinus aspirate using polymerase chain reaction

Published online by Cambridge University Press:  08 December 2009

S M El-Morsy ,
Y W Khafagy ,
M M El-Naggar  and
A A Beih
S M El-Morsy*
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, Mansoura University, Egypt
Y W Khafagy
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, Mansoura University, Egypt
M M El-Naggar
Affiliation:
Medical Microbiology and Immunology, Faculty of Medicine, Mansoura University, Egypt
A A Beih
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, Mansoura University, Egypt
*
Address for correspondence: Dr Shawky Mahmoud El-Morsy, Assistant Professor of Otolaryngology, Mansoura University, Faculty of Medicine Otorhinolaryngology Department, Elgomhoria street, Mansoura, PO 35516, Egypt-Dakhlia. Fax: +20502267016 E-mail: shawky_morsy2003@yahoo.com
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Abstract

Objective:

This study investigated allergic fungal rhinosinusitis cases, and aimed to compare the detection of fungi in sinus aspirate by culture and by polymerase chain reaction assay, and to relate the presence of fungi in the nasal sinuses to the type of fungal allergen causing disease.

Methods:

Sixty-eight cases of allergic fungal rhinosinusitis underwent fungal culture and polymerase chain reaction assay for universal fungal, aspergillus and bipolaris DNA. Aspergillus-specific immunoglobulin E levels were measured in sinus aspirate, and total serum immunoglobulin E levels were calculated. A control group of 10 cases was included in the study.

Results:

Of the 68 allergic fungal rhinosinusitis cases, only 42 (61.7 per cent) had positive fungal cultures; of the 10 controls, only three (30 per cent) had positive cultures. Species from the dematiaceous family were most commonly grown, being isolated in 30 cases (71.4 per cent). Bipolaris was the most commonly isolated species (18 cases) followed by curvularia (11 cases) and alternaria (one case). Polymerase chain reaction assay detected fungal DNA in all the allergic fungal rhinosinusitis cases and also in four controls (40 per cent). Ten patients (of 68; 14.7 per cent) were positive for Aspergillus fumigatus specific immunoglobulin E. The mean concentration of this immunoglobulin was 11.32 ± 4.12 IU/ml in patients and 0 IU/ml in controls, a statistically significant difference.

Conclusion:

Detection of fungal DNA in nasal aspirate by polymerase chain reaction was superior to fungal cultures as a method of detecting fungal growth. In allergic fungal rhinosinusitis, fungal growth is not always accompanied by an allergic reaction.

Keywords

FungusSinusitisAllergyPolymerase Chain Reaction
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 2 , February 2010 , pp. 152 - 160
Copyright
Copyright © JLO (1984) Limited 2009

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Footnotes

Presented at the Rhinology World 2009 conference, 15–19 April 2009, Philadelphia, Pennsylvania, USA.

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