title: Detection and identification of fungi from fungus balls of the maxillary sinus by molecular techniques.
abstract: The aim of this study was to find a reliable method for the detection and identification of fungi in fungus balls of the maxillary sinus and to evaluate the spectrum of fungi in these samples. One hundred twelve samples were obtained from patients with histologically proven fungal infections; 81 samples were paraffin-embedded tissue sections of the maxillary sinus. In 31 cases, sinus contents without paraffin embedding were sent for investigation. PCR amplification with universal fungal primers for 28S ribosomal DNA and amplicon identification by hybridization with species-specific probes for Aspergillus fumigatus, Aspergillus flavus, Aspergillus niger, Aspergillus terreus, Aspergillus glaucus, Pseudallescheria boydii, Candida albicans, and Candida glabrata were performed for all samples. Furthermore, PCR products were sequenced. Fresh samples were also cultivated. Fungal DNA was detected in all of the fresh samples but only in 71 paraffin-embedded tissue samples (87.7%). Sequence analysis was the most sensitive technique, as results could be obtained for 28 (90.3%) fresh samples by this method in comparison to 24 (77.4%) samples by hybridization and 16 (51.6%) samples by culture. However, sequence analysis delivered a result for only 36 (50.7%) of the paraffin-embedded specimens. Hybridization showed reliable results for A. fumigatus, which proved to be the most common agent in fungus balls of the maxillary sinus. Other Aspergillus species and other genera were rarely found.
authors.affiliation: Division of Clinical Microbiology, Institute of Hygiene and Medical Microbiology, University of Vienna, Vienna, Australia. birgit.willinger@akh-wien.ac.at
authors.forename: Birgit
authors.initials: B
authors.lastname: Willinger
authors.forename: Alexandra
authors.initials: A
authors.lastname: Obradovic
authors.forename: Brigitte
authors.initials: B
authors.lastname: Selitsch
authors.forename: Johann
authors.initials: J
authors.lastname: Beck-Mannagetta
authors.forename: Walter
authors.initials: W
authors.lastname: Buzina
authors.forename: Hannes
authors.initials: H
authors.lastname: Braun
authors.forename: Petra
authors.initials: P
authors.lastname: Apfalter
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Hirschl
authors.forename: Athanasios
authors.initials: A
authors.lastname: Makristathis
authors.forename: Manfred
authors.initials: M
authors.lastname: Rotter
mesh_terms: D004271:DNA, Fungal / Q000032:analysis; D004275:DNA, Ribosomal / Q000032:analysis; D005658:Fungi / Q000145:classification / Q000302:isolation & purification*; D006801:Humans; D008443:Maxillary Sinus / Q000382:microbiology*; D016133:Polymerase Chain Reaction
chemical_list: D004271:DNA, Fungal; D004275:DNA, Ribosomal