title: Detection of fungal organisms in eosinophilic mucin using a fluorescein-labeled chitin-specific binding protein.
abstract: BACKGROUND
  The ability to identify fungal hyphae in patients with chronic rhinosinusitis (CRS) has been inconsistent. A new fluorescein-labeled staining method targets chitin found in fungal cell walls.
  
  
  OBJECTIVE
  We hypothesize that this method would be able to more consistently detect fungi within the mucin of CRS patients.
  
  
  METHODS
  Fifty-four consecutive CRS surgical patients were evaluated. After ensuring sensitivity and specificity of this new method, all specimens were stained with either fluorescein-labeled chitinase or Grocott methanamine silver stain for comparison.
  
  
  RESULTS
  All 54 specimens contained eosinophilic mucin on hematoxylin and eosin staining. One or more fungal hyphae could be visualized within the mucin of 54 (100%) of 54 specimens stained using the fluorescein-labeled chitinase. Only 41 (76%) of 54 of the specimens stained with the Grocott methanamine silver stain technique demonstrated fungi.
  
  
  CONCLUSIONS
  The fluorescein-labeled chitinase-staining technique has greater sensitivity in detecting fungal organisms within eosinophilic mucin. Fungal organisms are present in the mucin of CRS patients.
authors.affiliation: Division of Allergy and Infection Diseases, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Taylor
authors.forename: Jens U
authors.initials: JU
authors.lastname: Ponikau
authors.forename: David A
authors.initials: DA
authors.lastname: Sherris
authors.forename: Eugene B
authors.initials: EB
authors.lastname: Kern
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Gaffey
authors.forename: Gail
authors.initials: G
authors.lastname: Kephart
authors.forename: Hirohito
authors.initials: H
authors.lastname: Kita
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002352:Carrier Proteins; D002686:Chitin / Q000302:isolation & purification*; D002688:Chitinases; D002908:Chronic Disease; D004802:Eosinophilia / Q000382:microbiology* / Q000473:pathology; D005260:Female; D005452:Fluoresceins; D005456:Fluorescent Dyes; D006801:Humans; D025301:Hyphae / Q000302:isolation & purification; D008297:Male; D008875:Middle Aged; D009077:Mucins / Q000302:isolation & purification*; D012220:Rhinitis / Q000382:microbiology* / Q000473:pathology; D012852:Sinusitis / Q000382:microbiology* / Q000473:pathology; D013194:Staining and Labeling / Q000379:methods*
chemical_list: D002352:Carrier Proteins; D005452:Fluoresceins; D005456:Fluorescent Dyes; D009077:Mucins; D002686:Chitin; D002688:Chitinases