title: Chronic rhinosinusitis: association of recalcitrant nasal polyposis and fungal finding in polyp's single-cell suspension.
abstract: In recent years fungi are favoured as origin of chronic rhinosinusitis (CRS), especially with nasal polyps (wNP). Sensitive methods for fungal detection are still absent, therefore we used NP tissue single-cell suspension for mycology investigations in patients with recalcitrant NP (rNP) that underwent functional endoscopic sinus surgery (FESS). A prospective case-series study and culture-based mycological examination were conducted in patients who underwent FESS for the first time (ft-FESS) and those with repeated FESS (re-FESS). The study was conducted in a tertiary Otorhinolaryngology Unit of Clinical Centre of Serbia. A total of 43 consecutive patients with CRSwNP underwent FESS. Culture-based mycological examination of single-cell suspension was done on 55 NPs samples. Patient's co-morbidity data were collected. Repeated FESS was observed in 19/43 (44 %) patients (re-FESS group). Asthma and aspirin intolerance were more frequent in re-FESS than in ft-FESS group (p = 0.000, p = 0.002; respectively). Fungi were detected (wF) in 10/43 (23.3 %) patients (FESSwF group), representing 13/55 culture positive NP tissue (23.6 %). Fungal presence was higher in re-FESS than in ft-FESS group (42 and 8 %, respectively; p = 0.01). Significantly longer duration of CRS was observed in FESSwF than in fungal negative patients (p = 0.033). Predominate strain was Aspergillus flavus detected in 6/10 patients. This is the first study which analysed association of fungi in single-cell suspension of NP tissue and rNP. We demonstrate significantly higher percentage of positive fungal finding in re-FESSwF than in ft-FESSwF group. The most commonly isolated species in our patients was A. flavus.
authors: Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, Dr Subotica 1, Belgrade, Serbia. aleksandrabarac85@gmail.com.
authors: Aleksandra
authors: A
authors: Barac
authors: Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, Dr Subotica 1, Belgrade, Serbia.
authors: Marina
authors: M
authors: Pekmezovic
authors: Clinic for Allergology and Immunology, Clinical Centre of Serbia, Belgrade, Serbia.|Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
authors: Vesna Tomic
authors: VT
authors: Spiric
authors: Faculty of Medicine, University of Belgrade, Belgrade, Serbia.|Clinic for Otorhinolaryngology and Maxillofacial Surgery, Clinical Centre of Serbia, Belgrade, Serbia.
authors: Aleksandar
authors: A
authors: Trivic
authors: Faculty of Medicine, Institute of Medical Statistics and Informatics, University of Belgrade, Belgrade, Serbia.
authors: Jelena
authors: J
authors: Marinkovic
authors: Faculty of Medicine, University of Belgrade, Belgrade, Serbia.|Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Centre of Serbia, Belgrade, Serbia.
authors: Sandra
authors: S
authors: Pekic
authors: Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, Dr Subotica 1, Belgrade, Serbia. mikomedlab2011@yahoo.com.
authors: Valentina Arsic
authors: VA
authors: Arsenijevic
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001231:Aspergillus flavus / Q000302:isolation & purification; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000382:microbiology* / Q000473:pathology*; D011446:Prospective Studies; D012220:Rhinitis / Q000382:microbiology*; D012852:Sinusitis / Q000382:microbiology*; D055815:Young Adult
keywords: Chronic rhinosinusitis; Functional endoscopic sinus surgery; Fungi; Recalcitrant nasal polyposis; Single-cell suspension; Tissue
references: Mayo Clin Proc. 1999 Sep;74(9):877-84
references: 10488788
references: Zhonghua Bing Li Xue Za Zhi. 2013 Jun;42(6):386-91
references: 24060072
references: Rhinology. 2012 Mar;50(1):1-12
references: 22469599
references: Lancet. 2010 Jan 30;375(9712):432
references: 20113828
references: Am J Rhinol. 2003 Jan-Feb;17(1):1-8
references: 12703478
references: Laryngoscope. 2008 Sep;118(9):1677-80
references: 18545212
references: Am J Rhinol. 2003 May-Jun;17(3):127-32
references: 12862399
references: Ann Saudi Med. 2009 May-Jun;29(3):212-4
references: 19448370
references: Indian J Otolaryngol Head Neck Surg. 2012 Dec;64(4):382-5
references: 24294585
references: Medicina (Kaunas). 2008;44(4):257-65
references: 18469501
references: Laryngoscope. 2004 May;114(5):811-3
references: 15126735
references: Rhinology. 2006 Mar;44(1):19-25
references: 16550945
references: Arch Otolaryngol Head Neck Surg. 1997 Jun;123(6):595-600
references: 9193219
references: Mycoses. 1999;42 Suppl 2:33-6
references: 10865901
references: Am J Rhinol. 1999 Sep-Oct;13(5):349-55
references: 10582112
references: Laryngoscope. 2014 Sep;124(9):E347-53
references: 24615892
references: Acta Medica (Hradec Kralove). 2011;54(2):83-6
references: 21842724
references: Int Arch Allergy Immunol. 2013;161 Suppl 2:147-53
references: 23711866
references: Laryngoscope. 2001 Jun;111(6):1006-19
references: 11404613
references: Curr Allergy Asthma Rep. 2003 Nov;3(6):523-31
references: 14531975
references: Otolaryngol Head Neck Surg. 2005 Jul;133(1):27-31
references: 16025048