title: Analysis of fungal ball rhinosinusitis by culturing fungal clumps under endoscopic surgery.
abstract: OBJECTIVE
  This study was designed to investigate the clinical microbiology of fungal ball (FB) rhinosinusitis by culturing fungal clumps collected under endoscopic surgery.
  
  
  METHODS
  From April to November of 2012, fungal clumps were sampled by endoscopic surgery from patients diagnosed with FB using clinical and histopathological methods. The specimens were subjected to smear microscopy, and cultured for bacteria and fungi analysis.
  
  
  RESULTS
  Out of the 81 specimens from 80 patients, 69 (69/81, 85.19%) specimens were detected a mixed infection of bacteria and fungi. However, only 25 (25/81, 30.86%) specimens resulted in fungal growth. There were 12 (12/81, 14.81%) specimens with fungal infections alone. The cultured fungi included 36 strains belonging to five genera, and most of them were Aspergillus spp. (30/36, 83.3%). The cultured bacteria included 94 strains belonging to 16 genera, and the most frequently seen was Staphylococcus spp. (23/94, 35.94%). When it was fungal and Pseudomonas aeruginosa mixed infection, the fungal growth was inhibited (P = 0.002).
  
  
  CONCLUSIONS
  Patients with fungal ball usually have mixed fungal and bacterial infections. The fungi from these samples are sometimes difficult to culture, which may be the result of the inhibition by bacteria in vitro and in vivo.
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, State Key Laboratory Otolaryngology Head and Neck Surgery of Ministry of Education, Beijing Tongren Hospital, Capital Medical University Beijing 100730, China ; Department of Otolaryngology, Daqing Oilfield General Hospital Daqing 163001, Heilongjiang Province, China.
authors.forename: Junyi
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, State Key Laboratory Otolaryngology Head and Neck Surgery of Ministry of Education, Beijing Tongren Hospital, Capital Medical University Beijing 100730, China.
authors.forename: Yunchuan
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Clinical Laboratory, Beijing Tongren Hospital, Capital Medical University Beijing 100730, China.
authors.forename: Xinxin
authors.initials: X
authors.lastname: Lu
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, State Key Laboratory Otolaryngology Head and Neck Surgery of Ministry of Education, Beijing Tongren Hospital, Capital Medical University Beijing 100730, China.
authors.forename: Xiangdong
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, State Key Laboratory Otolaryngology Head and Neck Surgery of Ministry of Education, Beijing Tongren Hospital, Capital Medical University Beijing 100730, China.
authors.forename: Hongrui
authors.initials: H
authors.lastname: Zang
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, State Key Laboratory Otolaryngology Head and Neck Surgery of Ministry of Education, Beijing Tongren Hospital, Capital Medical University Beijing 100730, China.
authors.forename: Tong
authors.initials: T
authors.lastname: Wang
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, State Key Laboratory Otolaryngology Head and Neck Surgery of Ministry of Education, Beijing Tongren Hospital, Capital Medical University Beijing 100730, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Zhou
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, State Key Laboratory Otolaryngology Head and Neck Surgery of Ministry of Education, Beijing Tongren Hospital, Capital Medical University Beijing 100730, China.
authors.forename: Luo
authors.initials: L
authors.lastname: Zhang
keywords: Fungal ball; clinical microbiology; fungal rhinosinusitis; microbial culture; mixed infections