Epidemiology and Medical Mycology of Fungal Rhinosinusitis

Shiv Sekhar Chatterjee; Arunaloke Chakrabarti

doi:10.5005/jp-journals-10003-1001

Epidemiology and Medical Mycology of Fungal Rhinosinusitis

Otorhinolaryngology Clinics - An International Journal ◽

10.5005/jp-journals-10003-1001 ◽

2009 ◽

Vol 1 (1) ◽

pp. 1-14 ◽

Cited By ~ 14

Author(s):

Shiv Sekhar Chatterjee ◽

Arunaloke Chakrabarti

Keyword(s):

Rhizopus Oryzae ◽

Pathogenic Fungi ◽

Medical Mycology ◽

Fungal Colonization ◽

Common Disease ◽

Fungal Sinusitis ◽

Dematiaceous Fungi ◽

Fungal Ball ◽

Fungal Rhinosinusitis ◽

Chronic Invasive

Abstract Fungal rhinosinusitis (FRS) refers to a spectrum of disease ranging from benign colonization of the nose and sinuses by pathogenic fungi to acute invasive and fatal inflammation extending to the orbit and brain. FRS is classified into two categories: invasive and noninvasive. Invasive FRS may again be subcategorized into acute invasive (fulminant) FRS, granulomatous invasive FRS, and chronic invasive FRS; while noninvasive FRS is subcategorized into localized fungal colonization, sinus fungal ball and eosinophil related FRS (including allergic fungal rhinosinusitis, eosinophilic fungal rhinosinusitis). This classification is not without controversies, and intermediate and semi-invasive forms may also exist in particular patients. Acute invasive FRS is an increasingly common disease worldwide among the immunocompromised patients and caused most frequently by Rhizopus oryzae, and Aspergillus spp. Granulomatous invasive FRS has mostly been reported from Sudan, India, and Pakistan and is characterized by noncaseating granuloma formation, vascular proliferation, vasculitis, perivascular fibrosis, sparse hyphae in tissue, and isolation of A. flavus from sinus contents. Chronic invasive FRS is an emerging entity occurring commonly in diabetics and patients on corticosteroid therapy, and is characterized by dense accumulation of hyphae, occasional presence of vascular invasion, sparse inflammatory reaction, involvement of local structures, and isolation of A. fumigatus. While localized fungal colonization describes the most benign of all fungal sinusitis in the superficial nasal crusts, sinus fungal ball is a dense mycetoma like aggregate of fungal hyphae in diseased sinuses. Common in southern Europe, especially France, majority of them are sterile on culture while 30-50% may yield Aspergillus spp. The definitions and pathogenesis of the group of syndromes in eosinophil related FRS (AFRS, EFRS) are contentious and a matter of intense research among otolaryngologists, pathologists, immunologists and microbiologists. While dematiaceous fungi are the foremost initiators of these syndromes in the west, Aspergillus flavus is the predominant pathogen in India and the Middle-East.

Allergen Immunotherapy in an HIV+ Patient with Allergic Fungal Rhinosinusitis

Case Reports in Immunology ◽

10.1155/2015/875260 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Ian A. Myles ◽

Satyen Gada

Keyword(s):

Allergen Immunotherapy ◽

Severe Infection ◽

Invasive Fungal Disease ◽

Fungal Disease ◽

Fungal Sinusitis ◽

Opportunistic Pathogens ◽

Fungal Rhinosinusitis ◽

Allergic Fungal Rhinosinusitis ◽

Invasive Fungal Rhinosinusitis ◽

Chronic Invasive

Patients with HIV/AIDS can present with multiple types of fungal rhinosinusitis, fungal balls, granulomatous invasive fungal rhinosinusitis, acute or chronic invasive fungal rhinosinusitis, or allergic fungal rhinosinusitis (AFRS). Given the variable spectrum of immune status and susceptibility to severe infection from opportunistic pathogens it is extremely important that clinicians distinguish aggressive fungal invasive fungal disease from the much milder forms such as AFRS. Here we describe a patient with HIV and AFRS to both remind providers of the importance of ruling out invasive fungal disease and outline the other unique features of fungal sinusitis treatment in the HIV-positive population. Additionally we discuss the evidence for and against use of allergen immunotherapy (AIT) for fungal disease in general, as well as the evidence for AIT in the HIV population.

Fungal Rhinosinusitis: A Radiological Review with Intraoperative Correlation

Canadian Association of Radiologists Journal ◽

10.1016/j.carj.2016.12.009 ◽

2017 ◽

Vol 68 (2) ◽

pp. 178-186 ◽

Cited By ~ 15

Author(s):

Elaine Ni Mhurchu ◽

Javier Ospina ◽

Arif S. Janjua ◽

Jason R. Shewchuk ◽

Alexandra T. Vertinsky

Keyword(s):

Invasive Disease ◽

Clinical Severity ◽

Fungal Colonization ◽

Tissue Destruction ◽

Tissue Invasion ◽

Fungal Rhinosinusitis ◽

Clinical Presentations ◽

Invasive Fungal Rhinosinusitis ◽

Chronic Invasive ◽

Histopathological Evidence

The interaction between fungi and the sinonasal tract results in a range of clinical presentations with a broad spectrum of clinical severity. The most commonly accepted classification system divides fungal rhinosinusitis into invasive and noninvasive subtypes based on histopathological evidence of tissue invasion by fungi. Invasive fungal rhinosinusitis is subdivided into acute invasive and chronic invasive categories. The chronic invasive category includes a subcategory of chronic granulomatous disease. Noninvasive fungal disease includes localized fungal colonization, fungal ball, and allergic fungal rhinosinusitis. Noninvasive disease is simply fungal material (or the products of the inflammatory reaction of the sinus mucosa) that fills the sinuses but does not invade tissue. Bone loss is related to expansion of the sinus(es). Invasive disease causes tissue destruction, such that it expands past the bony confines of the sinuses. It can rapidly spread, causing acute necrosis. Alternatively, there may be slow tissue invasion characterized by symptoms confused with normal sinusitis, but destruction of normal nasal and paranasal structures.

Chronic Invasive Fungal Rhinosinusitis in Immunocompetent Patients: A Retrospective Chart Review

Frontiers in Surgery ◽

10.3389/fsurg.2020.608342 ◽

2020 ◽

Vol 7 ◽

Author(s):

Naif H. Alotaibi ◽

Omar Abu Omar ◽

Mays Altahan ◽

Haifa Alsheikh ◽

Fawziah Al Mana ◽

...

Keyword(s):

Chart Review ◽

Tertiary Care ◽

Retrospective Chart Review ◽

Csf Leak ◽

Fungal Sinusitis ◽

Invasive Fungal Sinusitis ◽

Fungal Rhinosinusitis ◽

Invasive Fungal Rhinosinusitis ◽

Chronic Invasive ◽

Immunocompetent Patients

Objective: We report cases of Chronic Invasive Fungal Sinusitis (CIFS) in patients considered as immunocompetent at tertiary care center (King Faisal Specialist Hospital), to analyze their clinical, biological, radiological features, and management.Material and methods: A retrospective chart review of CIFS in immunocompetent patients. The inclusion criteria as the following: immunocompetent patients of any age with histopathological findings of CIFS. Immunocompromised patients, acute Invasive Fungal Sinusitis (IFS), non-invasive fungal rhinosinusitis, and no positive histological findings were excluded.Results: Seventeen (17) patients were included. The species isolated included: Aspergillus (most frequent) & Mucor. Surgical treatment approaches were described. Complications reported include CSF leak, blindness, recurrence, and death.Conclusions: Early diagnosis and management of CIFS improve clinical outcomes.

An Atypical Case of Chronic Invasive Fungal Sinusitis with Concurrent Fungal Ball

Journal of Clinical Otolaryngology ◽

10.35420/jcohns.2018.29.2.264 ◽

2018 ◽

Vol 29 (2) ◽

pp. 264-268

Author(s):

Young Do Jung ◽

Bo Mun Kim ◽

Byung Jun Kang ◽

Seung Heon Shin

Keyword(s):

Fungal Sinusitis ◽

Atypical Case ◽

Fungal Ball ◽

Invasive Fungal Sinusitis ◽

Chronic Invasive

Dynamics of fungal pathogens in host plant tissues

Canadian Journal of Botany ◽

10.1139/b95-388 ◽

1995 ◽

Vol 73 (S1) ◽

pp. 1275-1283 ◽

Cited By ~ 4

Author(s):

Shigehito Takenaka

Keyword(s):

Host Plant ◽

Species Interactions ◽

Fungal Biomass ◽

Quantitative Methods ◽

Plant Pathogens ◽

Pathogenic Fungi ◽

Molecular Methods ◽

Plant Colonization ◽

Fungal Colonization ◽

Plant Tissues

To develop efficient control measures against fungal plant pathogens, the dynamics of host plant colonization during disease development and the interactions among fungi within host plant tissues need to be clarified. These studies require accurate quantitative estimation of specific fungal biomass in plant tissues. This has been approached by direct-microscopic methods, cultural methods, chemical determinations of fungal components, serological methods, and molecular methods. Among these methods, serological and molecular methods provide rapid, specific, and sensitive quantitative measures of fungal biomass in host plant tissues. Therefore, studies on fungal dynamics of host plant colonization using these two methods are presented. Some examples of species interactions among pathogenic fungi within host plants, such as synergism and competition, are reviewed and the usefulness of serological and molecular methods for studies on these interactions is presented. These quantitative methods will provide helpful information for understanding the ecology of plant pathogenic fungi, such as the dynamics of host plant colonization and species interactions. Key words: quantitative methods, fungal biomass, ELISA, PCR, fungal colonization, species interaction.

Insect herbivory facilitates the establishment of an invasive plant pathogen

ISME Communications ◽

10.1038/s43705-021-00004-4 ◽

2021 ◽

Vol 1 (1) ◽

Author(s):

Martin M. Gossner ◽

Ludwig Beenken ◽

Kirstin Arend ◽

Dominik Begerow ◽

Derek Peršoh

Keyword(s):

Invasive Plant ◽

Pathogenic Fungus ◽

Feeding Activity ◽

Insect Herbivory ◽

Forest Health ◽

Mechanical Damage ◽

Pathogenic Fungi ◽

Fungal Colonization ◽

Feeding Damage ◽

The Impact

AbstractPlants can be severely affected by insect herbivores and phytopathogenic fungi, but interactions between these plant antagonists are poorly understood. We analysed the impact of feeding damage by the abundant herbivore Orchestes fagi on infection rates of beech (Fagus sylvatica) leaves with Petrakia liobae, an invasive plant pathogenic fungus. The fungus was not detected in hibernating beetles, indicating that O. fagi does not serve as vector for P. liobae, at least not between growing seasons. Abundance of the fungus in beech leaves increased with feeding damage of the beetle and this relationship was stronger for sun-exposed than for shaded leaves. A laboratory experiment revealed sun-exposed leaves to have thicker cell walls and to be more resistant to pathogen infection than shaded leaves. Mechanical damage significantly increased frequency and size of necroses in the sun, but not in shade leaves. Our findings indicate that feeding damage of adult beetles provides entry ports for fungal colonization by removal of physical barriers and thus promotes infection success by pathogenic fungi. Feeding activity by larvae probably provides additional nutrient sources or eases access to substrates for the necrotrophic fungus. Our study exemplifies that invasive pathogens may benefit from herbivore activity, which may challenge forest health in light of climate change.

Chronic Invasive Fungal Sinusitis With Negative Histopathology: A Diagnostic Challenge

Ear Nose & Throat Journal ◽

10.1177/0145561320973773 ◽

2021 ◽

pp. 014556132097377

Author(s):

Anne Ning ◽

Arminé Kocharyan ◽

W Colby Brown ◽

Brian D’Anza

Keyword(s):

Definitive Diagnosis ◽

Fungal Sinusitis ◽

Chain Reaction ◽

Diagnostic Challenge ◽

Invasive Fungal Sinusitis ◽

Fungal Organisms ◽

Fungal Dna ◽

Polymerase Chain ◽

Histopathologic Findings ◽

Chronic Invasive

Although the diagnosis of chronic invasive fungal sinusitis relies chiefly on identification of invasive fungi on histology, the insidious nature of the disease can preclude detection of fungal organisms. Here, we present a case of chronic invasive fungal sinusitis with negative histopathologic findings and a definitive diagnosis made through fungal DNA detection. Clinicians should consider polymerase chain reaction an important complement to histology and culture in the diagnosis of chronic invasive fungal sinusitis.

Chronic Invasive Fungal Rhinosinusitis: A Systematic Review and Meta-analysis

10.1055/s-0041-1725473 ◽

2021 ◽

Author(s):

Nrusheel Kattar ◽

Basit Jawad ◽

Muhib Haidari ◽

Ryan Winters

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Fungal Rhinosinusitis ◽

Invasive Fungal Rhinosinusitis ◽

Chronic Invasive

Evaluation of pathogenic fungi occurrence in traumatogenic structures of freshwater fish

Revista da Sociedade Brasileira de Medicina Tropical ◽

10.1590/s0037-86822011005000007 ◽

2011 ◽

Vol 44 (2) ◽

pp. 182-185 ◽

Cited By ~ 5

Author(s):

Fabio Caetano Oliveira Leme ◽

Marcos Mendes de Barros Negreiros ◽

Fernando Akira Koga ◽

Sandra de Moraes Gimenes Bosco ◽

Eduardo Bagagli ◽

...

Keyword(s):

Freshwater Fish ◽

Fungal Infections ◽

Pathogenic Fungi ◽

Dematiaceous Fungi ◽

Candida Spp ◽

Pathogenic Potential ◽

Infection Route ◽

5.8S Rdna ◽

Dorsal Fin ◽

Pimelodus Maculatus

INTRODUCTION: Fungal infections in human skin, such as sporotrichosis, can occur after fish induced trauma. This work aimed to identify fungi in freshwater fish that are pathogenic to humans. METHODS: Extraction of dental arches from Serrassalmus maculatus (piranha) and Hoplias malabaricus (wolf fish), stings from Pimelodus maculatus (mandis catfish), dorsal fin rays from Plagioscion spp. (corvina) and Tilapia spp., for culture in Mycosel agar. Some cultures were submitted to DNA extraction for molecular identification by sequencing ITS-5.8S rDNA. RESULTS: Cultures identified most yeast as Candida spp., while sequencing also permitted the identification of Phoma spp. and Yarrowia lipolytica. CONCLUSIONS: While the search for S. schenckii was negative, the presence of fungus of the genera Phoma and Candida revealed the pathogenic potential of this infection route. The genus Phoma is involved in certain forms of phaeohyphomycosis, a subcutaneous mycosis caused by dematiaceous fungi, with reports of infections in human organs and systems. Traumatizing structures of some freshwater fish present pathogenic fungi and this may be an important infection route that must be considered in some regions of Brazil, since there are a large number of a fisherman in constant contact with traumatogenic fish.

Allergic fungal rhinosinusitis: an overview on pathogenesis, early diagnosis and management

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20181853 ◽

2018 ◽

Vol 4 (3) ◽

pp. 694 ◽

Cited By ~ 1

Author(s):

Neeraj Suri ◽

Bhavya B. M.

Keyword(s):

Nasal Obstruction ◽

Endoscopic Sinus Surgery ◽

Sinus Surgery ◽

Histological Evaluation ◽

Nasal Discharge ◽

Fungal Sinusitis ◽

Surgical Specimen ◽

Specimen Handling ◽

Fungal Rhinosinusitis ◽

Allergic Fungal Rhinosinusitis

Background: The objective of the study was to evaluate the criteria for diagnosing allergic fungal rhinosinusitis and to maintain permanent drainage and ventilation, while preserving the integrity of the mucosa.Methods: This is a prospective study of 50 patients with allergic fungal sinusitis with or without polyposis all of whom were treated with endoscopic debridement. Mucous sample collection, nasal secretion culture, surgical specimen handling, and histological evaluation of surgical specimens are described. All patients treated with endoscopic sinus surgery, debridement, post-operative use of steroids and antifungal therapy. Results: Fungal mucin was found in all 50 cases, histology and fungal cultures confirmed the diagnosis. Out of 50 patients, 29 were females and 21 were males, with a mean age of 32 years. The most common symptom was nasal discharge 41 (82%) cases, nasal obstruction in 38 (76%) cases, headache and facial pain in 32 (72%) cases, 7 (14%) patients had bronchial asthma. Symptoms of nasal obstruction and nasal discharge were improved in 46 (92%) cases. All preoperative versus postoperative changes in AFRS associated complaints reached statistical significance of p value <0.001 except in patients with asthma.Conclusions: Comprehensive management with endoscopic sinus surgery, oral steroids and antifungals reduces the recurrence or need for revision surgery. Long term follow up is very important.