title: Effect of using multiple culture media for the diagnosis of noninvasive fungal sinusitis.
abstract: BACKGROUND
  This study was designed to assess the relative efficiency of three different culture media for isolating fungi in patients suspected of having noninvasive fungal sinusitis.
  
  
  METHODS
  A prospective study was performed of 209 operative samples of sinus "fungal-like" mucin from 134 patients on 171 occasions and processed for microscopy and fungal culture in Sabouraud's dextrose agar, potato dextrose agar, and broth media.
  
  
  RESULTS
  Ninety-three (69%) of 134 patients had evidence of fungal infection. Two-thirds of patients had negative microscopy samples yet 56% of these went on to positive cultures. Forty-five percent cultured Aspergillus genus. Discrepancy between the fungi cultured in different media and on different occasions was common. With a single culture medium up to 19% of patients and 15% of samples would have been falsely labeled fungal negative.
  
  
  CONCLUSIONS
  Increasing the number and type of fungal culture media used increases the number and range of fungal isolates from mucin in patients with the features of fungal sinusitis. Negative specimen microscopy is unreliable. All specimens should be cultured in multiple media and on multiple occasions when fungal sinusitis is suspected.
authors.affiliation: Department of Surgery-Otolaryngology Head and Neck Surgery, The University of Adelaide and Flinders University of South Australia, South Australia, Australia.
authors.forename: Melanie M
authors.initials: MM
authors.lastname: Collins
authors.forename: Salil B
authors.initials: SB
authors.lastname: Nair
authors.forename: Vanik
authors.initials: V
authors.lastname: Der-Haroutian
authors.forename: David
authors.initials: D
authors.lastname: Close
authors.forename: Guy L
authors.initials: GL
authors.lastname: Rees
authors.forename: David I
authors.initials: DI
authors.lastname: Grove
authors.forename: Peter-John
authors.initials: PJ
authors.lastname: Wormald
mesh_terms: D000362:Agar; D000900:Anti-Bacterial Agents; D001228:Aspergillosis / Q000175:diagnosis* / Q000382:microbiology; D001230:Aspergillus / Q000187:drug effects / Q000254:growth & development / Q000302:isolation & purification*; D002701:Chloramphenicol; D003470:Culture Media; D004338:Drug Combinations; D005839:Gentamicins; D006801:Humans; D066298:In Vitro Techniques; D009077:Mucins; D010256:Paranasal Sinuses / Q000382:microbiology*; D011446:Prospective Studies; D015203:Reproducibility of Results; D012852:Sinusitis / Q000175:diagnosis* / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D003470:Culture Media; D004338:Drug Combinations; D005839:Gentamicins; D009077:Mucins; D002701:Chloramphenicol; D000362:Agar