Detection of Fungi in Sinus Fluid of Patients with Allergic Fungal Rhinosinusitis

Abstract

We aim to develop a rapid, accurate and sensitive diagnostic assay with which to detect the surface antigens of fungi thought to be involved in allergic fungal rhinosinusitis (AFRS), by assessing the usefulness of immunofluorescence microscopy (IMF) and enzyme linked immuno-absorbent assays (ELISA). The age, sex, clinical symptoms and signs, imaging (CT and/or MRI), microbiological subculture data, sinus contents, blood eosinophilia, aspergillosis precipitins, radioallergoabsorbent technology (RAST) for fungal allergens and histopathology were performed on individuals undergoing endoscopic sinus surgery for suspected AFRS. Thirteen patients were examined, and five monoclonal antibodies raised to the surface washings of various fungi were found to recognize and differentiate between fungal species implicated in sinus disease, i.e. Aspergillus niger, Alternaria alternata, Cochliobolus lunata, Penicillium expansum and Cladosporium species. The IMF microscopy proved to be a useful assay to distinguish visually between the cultured fungi, but was less useful for visualization of fungi in the patient samples. However, ELISA assays with 5 monoclonal antibodies gave clear and unambiguous data as to the presence of certain fungi within the patient samples. There is good correlation between the ELISA data and the pathology findings. This preliminary study suggests that both IMF and ELISA techniques may offer an important advance in this area.

Investigation of Fungi in Massive Nasal Polyps: Microscopy, Culture, Polymerase-Chain Reaction, and Serology

“…Karpovich-Tate et al reported that ELISA and pathological examination results are correlated in their preliminary study. 24 Fungal organisms detected in our study were Aspergillus, Cladosporium, Debaryomyces, Neurospora, Penicillium, and Ustilago. Our results are similar to data in the literature ( except for the absence of Alternaria.…”

Health and Safety Effects of Airborne Soil Dust in the Americas and Beyond

“…Direct count analyses of topsoil from various desert environments show that bacterial and viral populations range from ∼10 3 to 10 7 per gram (Gonzalez- Martin et al, 2013). Fungal populations typically occur at ∼10 6 per gram (Karpovich-Tate, 2000). Bacteria are present in wind eroded sediments in which the overall composition is determined by soil type and management, as well as dust particle size (Gardner et al, 2012).…”

Allergic Fungal Rhinosinusitis in Saudi Arabia: A Review of Recent Literature

“…The remaining cases are attributed to the Aspergillus genus [ 48 ]. Routine, special, or immunofluorescence staining can help to increase the yield of fungal detection [ 49 ]. However, as false positives and false negatives can exist, fungal culture needs to be approached with caution [ 8 ].…”