Mohammadi Abdolrasoul, Hashemi Seyed Mostafa, Abtahi Sayed Hamidreza, Lajevardi Seyed Mohammad, Kianipour Sahar, Mohammadi Rasoul
Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Otolaryngology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
J Res Med Sci. 2017 May 30;22:67. doi: 10.4103/jrms.JRMS_166_17. eCollection 2017.
Fungal sinusitis is increasing worldwide in the past two decades. It is divided into two types including invasive and noninvasive. Noninvasive types contain allergic fungal sinusitis (AFS) and fungus ball. AFS is a hypersensitivity reaction to fungal allergens in the mucosa of the sinonasal tract in atopic individuals. The fungus ball is a different type of noninvasive fungal rhinosinusitis which is delineated as an accumulation of debris and fungal elements inside a paranasal sinus. Fungal sinusitis caused by various fungi such as species, , , , and phaeohyphomycetes. The aim of the present study is to identify fungal species isolated from noninvasive fungal sinusitis by molecular methods.
During 2015-2016, a total of 100 suspected patients were examined for fungal sinusitis. Functional endoscopic sinus surgery was performed using the Messerklinger technique. Clinical samples were identified by phenotypic and molecular methods. Polymerase chain reaction (PCR) sequencing of ITS1-5.8S-ITS2 region and PCR-restriction fragment length polymorphism with I restriction enzyme was performed for molecular identification of molds and yeasts, respectively.
Twenty-seven out of 100 suspected cases (27%) had fungal sinusitis. Nasal congestion (59%) and headache (19%) were the most common clinical signs among patients. Fifteen patients (55.5%) were male and 12 patients (44.5%) were female. was the most prevalent fungal species (26%), followed by (18.5%) and species complex (15%).
Since clinical manifestations, computed tomography scan, endoscopy, and histopathological findings are very nonspecific in AFS and fungus ball; therefore, molecular investigations are compulsory for precise identification of etiologic agents and appropriate management of these fungal infections.
在过去二十年中，真菌性鼻窦炎在全球范围内呈上升趋势。它分为侵袭性和非侵袭性两种类型。非侵袭性类型包括变应性真菌性鼻窦炎（AFS）和真菌球。AFS是特应性个体鼻窦黏膜对真菌过敏原的超敏反应。真菌球是一种不同类型的非侵袭性真菌性鼻窦炎，被描述为鼻窦内碎屑和真菌成分的积聚。真菌性鼻窦炎由多种真菌引起，如 种、 、 、 以及暗色丝孢霉。本研究的目的是通过分子方法鉴定从非侵袭性真菌性鼻窦炎中分离出的真菌种类。
在2015年至2016年期间，共对100例疑似真菌性鼻窦炎患者进行了检查。采用Messerklinger技术进行功能性鼻内镜鼻窦手术。通过表型和分子方法对临床样本进行鉴定。分别对ITS1 - 5.8S - ITS2区域进行聚合酶链反应（PCR）测序以及用I型限制性内切酶进行PCR - 限制性片段长度多态性分析，以对霉菌和酵母菌进行分子鉴定。
100例疑似病例中有27例（27%）患有真菌性鼻窦炎。鼻塞（59%）和头痛（19%）是患者中最常见的临床症状。15例患者（55.5%）为男性，12例患者（44.5%）为女性。 是最常见的真菌种类（26%），其次是 （18.5%）和 种复合体（15%）。
由于AFS和真菌球的临床表现、计算机断层扫描、内镜检查和组织病理学检查结果都非常不具有特异性；因此，分子研究对于准确鉴定病原体以及对这些真菌感染进行适当管理是必不可少的。
