The Potential of Iodine Lactoglycerol as an Alternative Fungal Stain in the Laboratory

Fungi are eukaryotic and opportunistic organisms that can cause damage and disease. Fungi can be identified by direct staining. The composition of the dyes used in fungi staining are toxic, mutagenic and harmful to laboratory personnel and the environment. Consequently, it is necessary to consider use fungi dye continuously, so its need alternative safety dyes to identify fungi in the laboratory. This research aims to determine the potential of iodine lactoglycerol with different concentrations (1.25%, 2.5%, and 5%) as an alternative dye for fungi in the laboratory. The research method used experimental design. The samples originate from moldy bread and made 27 of microscopic slides. The microscopic slides were observed with objective 40x magnification. The parameters assessed in this study were the structure and morphology of fungi including hyphae, conidiophores, vesicles, sterigmata and conidiospores and color intensity using the image analysis of ImageJ. The results showed that various concentrations of iodine lactoglycerol can staining the structure and morphology of the fungi properly and clearly. The value of color intensity of each concentration measured has a different average. The highest average value of color intensity concentration was 5% and the lowest was 1.25%. However, the result of ANOVA test showed a significance of 0.380 (P> 0.05), which means that is no difference significantly from three of various concentrations. The result showed that the difference concentration of iodine lactoglycerol does not affect the color intensity. The conclusion of this study was iodine lactoglycerol solution can be used as an alternative dye or Lactophenol-cotton Blue (LPCB) substitute for fungi identification. It is recommendation for further research be carried out regarding the decrease in the concentration of alternative color solutions below 1.25%, the incubation time for the preparation of the preparations, and the color stability of the prepared mushroom preparations.

Chronic Granulomatous Invasive Fungal Sinusitis: A Case Series and Literature Review

Chronic granulomatous invasive fungal sinusitis (CGIFS) is a peculiar disease of the paranasal sinuses due to its rarity, patient subset, and disease course. We describe 7 cases of histopathologically confirmed CGIFS with different treatment plans and varying outcomes. Of particular note was that one of these patients developed allergic fungal rhinosinusitis after complete resolution of his primary invasive disease, a finding that has never been reported in the literature. Another patient had an atypical fungal species ( Aspergillus nidulans) on fungal stain and culture, while one immunodeficient patient had a large intracerebral disease component and died after 2 months of treatment. We also present a review of the pertinent literature investigating this rare disease.

Allergic Fungal rhino-sinusitis frequency in chronic rhino-sinusitis patients and accuracy of fungal culture in its diagnosis

Objective: To determine the frequency of Allergic Fungal Rhino-sinusitis (AFRS) in Chronic Rhino-sinusitis (CRS) patients and the accuracy of fungal culture in diagnosing AFRS. Methods: Immunocompetent patients with CRS and without invasive fungal rhino-sinusitis presenting over a period of 3 years in ENT department of Mayo Hospital, from April 2014 to September 2017 were included in the study. AFRS was diagnosed clinically and on Bent and Kuhn diagnostic criteria. All patients underwent endoscopic sinus surgery. Removed tissue histopathology and fungal culture was done. Diagnostic accuracy of fungal culture in AFRS patients was determined. Results: Out of 216 patients of CRS, 45 (20.8%) had AFRS. Mean age of patients diagnosed with AFRS was 29.49±9.16. Out of 45 patients, 26 were male and 19 were female. Nasal polyps were present in 45 (100%) patients, fungal stain was positive in 39(86.7%). CT scan showed sinus expansion in 28(62.2%) patients, heterogeneous opacity in 45(100%) patients and bone destruction in 13(28.9%). Presence of Allergic Mucin was seen in 45(100%) patients, high IgE levels in 36(80.0%), eosinophilia in 21(46.7%), presence of Charcot Leyden crystals in 27(60.0%). Asymmetrical involvement of sinuses was seen in 30 (66.7%) and co-existent asthma was seen in 18(40.0%). Fungal culture positive patients were 25(55.6%). Diagnostic accuracy of fungal culture was 91.6%. Conclusion: Fungal culture has a key role in confirming diagnosis of AFRS. We also noted that frequency of AFRS is increasing in CRS patients. doi: https://doi.org/10.12669/pjms.36.3.1661 How to cite this:Awan NU, Cheema KM, Naumeri F, Qamar S. Allergic Fungal rhino-sinusitis frequency in chronic rhino-sinusitis patients and accuracy of fungal culture in its diagnosis. Pak J Med Sci. 2020;36(3):---------. doi: https://doi.org/10.12669/pjms.36.3.1661 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Fungal Infection: A Hidden Enemy in Diabetic Foot Ulcers

ABSTRACT Diabetic foot ulcers are on the rise and increasingly associated with amputations. Fungal infections have recently been implicated in the nonhealing nature of these wounds. One hundred five patients treated as in-patients with nonhealing diabetic ulcers in a tertiary care hospital were included in this prospective study. Wound swabs and deep tissue biopsies were taken from these ulcers for fungal stain and culture and bacterial culture. Once the fungal stain or the culture study is positive, oral Fluconazole was started. Nineteen patients grew fungus in the ulcer, commonest species being Candida tropicalis (10.5%). The most common bacterial organism isolated with fungal infection is Pseudomonas followed by Enterococcus. Patients on prolonged antibiotic therapy showed statistically significant increase in fungal infection. Patients who underwent amputation within 15 days of admission were higher in fungal culture positive group, due to progression of ulcer in spite of antibiotic therapy. There is a definite correlation between incidence of amputation and fungal infection in whom antifungal therapy was not started, though not statistically significant. Fourteen patients, who did not undergo amputation, had faster wound healing and lesser progression of disease, with none of them requiring amputation after initiating antifungal therapy. Our study reveals that there is a definite relation between fungal infections and nonhealing nature of diabetic ulcers. Further randomized trials are necessary to substantiate this finding. How to cite this article Sanniyasi S, Balu J, Narayanan CD. Fungal Infection: A Hidden Enemy in Diabetic Foot Ulcers. J Foot Ankle Surg (Asia-Pacific) 2015;2(2):74-76.