Mohapatra Samir, Barik Manas Ranjan, Rath Suryasnata, Sharma Savitri, Mohapatra Archisman, Behera Sharmistha, Acharya Souvagini, Pattjoshi Dipti Ranjan, Padhi Rajesh Kumar, Behera Himansu Sekhar
Department of Ophthalmic Plastic and Reconstructive Surgery Service, L V Prasad Eye Institute, Mithu Tulsi Chanrai Campus, Bhubaneswar 751024, Odisha, India.
Ocular Microbiology Service, L V Prasad Eye Institute, Mithu Tulsi Chanrai Campus, Bhubaneswar 751024, Odisha, India.
J Fungi (Basel). 2022 Aug 11;8(8):844. doi: 10.3390/jof8080844.
Early diagnosis and treatment of rhino-orbital-cerebral mucormycosis (ROCM) are crucial. Potassium hydroxide with Calcofluorwhite (KOH + CFW) smears can demonstrate the fungal hyphae, but mixed infections caused by both mucorales and non-mucorales pose a diagnostic challenge. Polymerase chain reaction (PCR) can detect mixed infections and differentiate mucorales from non-mucorales. This study aimed to evaluate the utility of a single reaction PCR in the diagnosis of ROCM and the efficacy of nasal biopsy and endonasal swab in the detection of fungus. clinical samples were collected from 33 patients and were subjected to KOH + CFW smear, culture and PCR. PCR was performed using pan-fungal primers targeting the 28S large subunit rRNA gene, and the amplified products were further sequenced to identify the fungi. KOH + CFW smear, culture and PCR detected mucorales in 54.6%, 27.3% and 63.6% patients, respectively. PCR detected mixed infection in 51.5% patients compared to 9.1% by KOH + CFW smear. PCR detected fungus in 90% of nasal biopsies and 77.8% of endonasal swabs. spp. was the most common fungi identified in 43.2% of PCR-positive samples. PCR is effective in detecting mixed infection and in the diagnosis of ROCM. Nasal biopsies had better fungal detection rates than endonasal swabs.
鼻眶脑型毛霉菌病（ROCM）的早期诊断和治疗至关重要。氢氧化钾与荧光增白剂（KOH + CFW）涂片可显示真菌菌丝，但毛霉目和非毛霉目引起的混合感染带来了诊断挑战。聚合酶链反应（PCR）可检测混合感染并区分毛霉目和非毛霉目。本研究旨在评估单反应PCR在ROCM诊断中的效用以及鼻活检和鼻内拭子在真菌检测中的效能。从33例患者中采集临床样本，进行KOH + CFW涂片、培养和PCR检测。使用靶向28S大亚基rRNA基因的泛真菌引物进行PCR，对扩增产物进一步测序以鉴定真菌。KOH + CFW涂片、培养和PCR分别在54.6%、27.3%和63.6%的患者中检测到毛霉目。与KOH + CFW涂片检测到的9.1%相比，PCR在51.5%的患者中检测到混合感染。PCR在90%的鼻活检和77.8%的鼻内拭子中检测到真菌。 spp.是在43.2%的PCR阳性样本中鉴定出的最常见真菌。PCR在检测混合感染和ROCM诊断中有效。鼻活检的真菌检测率高于鼻内拭子。
