title: Some chronic rhinosinusitis patients have elevated populations of fungi in their sinuses.
abstract: OBJECTIVE
  To measure the populations of 36 fungi in the homes and sinuses of chronic rhinosinusitis (CRS) and non-CRS patients.
  
  
  METHODS
  Single-blind cross-sectional study.
  
  
  METHODS
  Populations of 36 fungi were measured in sinus samples and in the home vacuum cleaner dust of CRS (n = 73) and non-CRS patients (n = 16) using quantitative polymerase chain reaction. Etest strips containing amphotericin B, anidulafungin, caspofungin, fluconazole, and voriconazole were used to test the susceptibility of seven potentially relevant fungi.
  
  
  RESULTS
  Seven fungi (Alternaria alternata, Cladosporium cladosporioides types 1 and 2, Cladosporium herbarum, Penicillium brevicompactum, Penicillium crustosum, and Penicillium chrysogenum type 2) were discovered at very high concentrations in some CRS patients. In vitro antifungal susceptibility testing of these seven fungi demonstrated species specific sensitivities. Four CRS patients with marked elevations of fungal populations in their sinus samples underwent endoscopic sinus surgery. After surgical treatment, the fungal populations were reduced by several orders of magnitude.
  
  
  CONCLUSIONS
  Seven fungi were found in very high concentrations in the sinuses of some CRS patients. Not one of the five common antifungal agents could control all seven of these fungi based on in vitro tests.
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, University of California, San Francisco School of Medicine, San Francisco, California, USA.
authors.forename: Andrew H
authors.initials: AH
authors.lastname: Murr
authors.forename: Andrew N
authors.initials: AN
authors.lastname: Goldberg
authors.forename: Steven D
authors.initials: SD
authors.lastname: Pletcher
authors.forename: Kelsey
authors.initials: K
authors.lastname: Dillehay
authors.forename: Larry J
authors.initials: LJ
authors.lastname: Wymer
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Vesper
mesh_terms: D002908:Chronic Disease; D003430:Cross-Sectional Studies; D004391:Dust; D005658:Fungi / Q000302:isolation & purification*; D006794:Household Articles; D006801:Humans; D012220:Rhinitis / Q000150:complications / Q000382:microbiology*; D016037:Single-Blind Method; D012852:Sinusitis / Q000150:complications / Q000382:microbiology*
chemical_list: D004391:Dust