Rapid detection and differentiation of Aspergillus and Mucorales species in fungal rhinosinusitis diagnosis are desirable, since the clinical management and prognosis associated with the two taxa are fundamentally different. We describe an assay based on a combination of broad-range PCR amplification and reverse line blot hybridization (PCR/RLB) to detect and differentiate the pathogens causing fungal rhinosinusitis, which include five Aspergillus species (A. fumigatus, A. flavus, A. niger, A. terreus, and A. nidulans) and seven Mucorales species (Mucor heimalis, Mucor racemosus, Mucor cercinelloidea, Rhizopus arrhizus, Rhizopus microsporus, Rhizomucor pusillus, and Absidia corymbifera). The assay was validated with 98 well-characterized clinical isolates and 41 clinical tissue specimens. PCR/RLB showed high sensitivity and specificity, with 100% correct identifications of 98 clinical isolates and no cross-hybridization between the species-specific probes. Results for five control isolates, Candida albicans, Fusarium solani, Scedosporium apiospermum, Penicillium marneffei, and Exophiala verrucosa, were negative as judged by PCR/RLB. The analytical sensitivity of PCR/RLB was found to be 1.8 ؋ 10 Rhinosinusitis is a common disease with multiple manifestations and can even cause death in acute invasive cases. Fungi are considered to be major etiological agents, of which members of the order Mucorales and genus Aspergillus (order Eurotiales) are the most pathogenic (5, 10, 13). The course, therapeutic treatment, and prognosis of fungal rhinosinusitis caused by Aspergillus and Mucorales species are radically different; therefore, early diagnosis and accurate identification of pathogenic fungal species are crucial for effective treatment and clinical decision-making (21). Currently, diagnosis of fungal sinusitis still depends on histopathological examination and culture from nasal biopsy, but conventional culture-based phenotypic identification techniques often include significant delays and can fail to yield growth in clinical samples (17). In a significant number of cases, fungal culture is negative and only formalin-fixed paraffin-embedded (PE) tissue specimens are available for diagnosis of fungal infection. However, rapid diagnosis of surgical tissues is urgently needed in acute invasive infection cases. In addition, histopathological observations of fungal shape and arrangement may not be sufficient for the accurate identification of fungal species if only a limited quantity of anamorphic fungal hyphae is present. Therefore, to improve the outcome for fungal rhinosinusitis patients, the rapid and accurate detection and identification of pathogenic fungal species are needed to allow early initiation of targeted therapy.In this study, we developed an assay combining broad-range PCR amplification and reverse line blot hybridization (PCR/ RLB) to detect and differentiate Aspergillus and Mucorales pathogens in tissue specimens. The fungal pathogens tested included five Aspergillus species (Aspergillus fumigatus, A. f...