1887

Journal of Medical Microbiology logo

Volume 56, Issue 10

Negative impact of galactomannan and DNA detection in the diagnosis of fungal rhinosinusitis Free

Abstract

A proportion of patients with chronic rhinosinusitis, especially if nasal polyps are present, have a diagnosis of fungal rhinosinusitis. The diagnosis is difficult to establish because the symptoms and clinical and radiological signs are non-specific. Also current diagnostic methods, i.e. histology, fungal staining and culture, are insensitive. The performance of the galactomannan (GM) ELISA and real-time PCR for mitochondrial DNA was evaluated for the detection of in sinus mucus samples from 25 patients with chronic rhinosinusitis with nasal polyposis. The results were compared with those from nasal lavage fluid from 19 healthy volunteers. Seven patients (28 %) were diagnosed as having fungal rhinosinusitis according to the presence of filaments in histology or direct microscopy using Calcofluor white. All fungal rhinosinusitis patients were negative in the GM ELISA. GM ELISA was positive in five patients whose samples were negative using conventional methods and PCR. Two out of seven patients with fungal rhinosinusitis were positive by PCR: one also had a positive culture, and one had hyphae consistent with in histology. One additional patient had a weak positive PCR result, but other fungal tests were negative. In control subjects, the GM ELISA was positive in 21 %, whereas direct microscopy, culture and PCR were negative in all samples. Direct microscopy and culture together with histology remain pivotal in defining fungal rhinosinusitis diagnosis. PCR may have additional value in allowing the diagnosis to be made sooner, whereas the GM ELISA is not reliable in diagnosing infection of the paranasal sinuses.

  • Received:
  • Accepted:
  • Published Online:
Keyword(s): CRS, chronic rhinosinusitis , CRSwNP, chronic rhinosinusitis with nasal polyposis , CT, threshold cycle , GM, galactomannan and NAL, nasal lavage
SGM
Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.47101-0
2007-10-01
2024-04-26
Loading full text...

Full text loading...

/deliver/fulltext/jmm/56/10/1322.html?itemId=/content/journal/jmm/10.1099/jmm.0.47101-0&mimeType=html&fmt=ahah

References

  1. Ansorg R., van den Boom R., Rath P. M. 1997; Detection of Aspergillus galactomannan antigen in foods and antibiotics. Mycoses 40:353–357 [CrossRef]
     [Google Scholar]
  2. Ascioglu S. J., Rex H., de Pauw B., Bennett J. E., Billie J., Crokaert F., Denning D. W., Donnelly J. P., Edwards J. E. other authors 2002; Defining opportunistic invasive fungal infections in immunocompromised patients with cancer and hematopoietic stem cell transplants: an international consensus. Clin Infect Dis 34:7–14 [CrossRef]
     [Google Scholar]
  3. Braun H., Buzina W., Freudenschuss K., Beham A., Stammberger H. 2003; ‘Eosinophilic fungal rhinosinusitis’: a common disorder in Europe?. Laryngoscope 113:264–269 [CrossRef]
     [Google Scholar]
  4. Buzina W., Braun H., Freudenschuss K., Lackner A., Habermann W., Stammberger H. 2003; Fungal biodiversity – as found in nasal mucus. Med Mycol 41:149–161
     [Google Scholar]
  5. Catten M. D., Murr A. H., Goldstein J. A., Mhatre A. N., Lalwani A. K. 2001; Detection of fungi in the nasal mucosa using polymerase chain reaction. Laryngoscope 111:399–403 [CrossRef]
     [Google Scholar]
  6. Costa C., Costa J. M., Desterke C., Botterel F., Cordonnier C., Bretagne S. 2002; Real-time PCR coupled with automated DNA extraction and detection of galactomannan antigen in serum by enzyme-linked immunosorbent assay for diagnosis of invasive aspergillosis. J Clin Microbiol 40:2224–2227 [CrossRef]
     [Google Scholar]
  7. deShazo R. D. 1998; Fungal sinusitis. Am J Med Sci 316:39–45 [CrossRef]
     [Google Scholar]
  8. deShazo R. D., O'Brien M., Chapin K., Soto-Aguilar M., Gardner L., Swain R. 1997; A new classification and diagnostic criteria for invasive fungal sinusitis. Arch Otolaryngol Head Neck Surg 123:1181–1188 [CrossRef]
     [Google Scholar]
  9. Fokkens W., Lund V., Bachert C., Clement P., Hellings P., Holmstrom M., Jones N., Kalogjera L., Kennedy D. other authors 2005; European position paper on chronic rhinosinusitis and nasal polyps. Rhinology 18 ( Suppl. ):S1–S87
     [Google Scholar]
  10. Giacchino M., Chiapello N., Bezzio S., Fagioli F., Saracco P., Alfarano A., Martini V., Cimino G., Martino P., Girmenia C. 2006; Aspergillus galactomannan enzyme-linked immunosorbent assay cross-reactivity caused by invasive Geotrichum capitatum . J Clin Microbiol 44:3432–3434 [CrossRef]
     [Google Scholar]
  11. Granville L., Chirala M., Cernoch P., Ostrowski M., Truong L. D. 2004; Fungal sinusitis: histologic spectrum and correlation with culture. Hum Pathol 35:474–481 [CrossRef]
     [Google Scholar]
  12. Herbrecht R., Letscher-Bru V., Oprea C., Lioure B., Waller J., Campos F., Villard O., Liu K. L., Natarajan-Ame S. other authors 2002; Aspergillus galactomannan detection in the diagnosis of invasive aspergillosis in cancer patients. J Clin Oncol 20:1898–1906 [CrossRef]
     [Google Scholar]
  13. Hirvonen M. R., Ruotsalainen M., Roponen M., Hyvarinen A., Husman T., Kosma V. M., Komulainen H., Savolainen K., Nevalainen A. 1999; Nitric oxide and proinflammatory cytokines in nasal lavage fluid associated with symptoms and exposure to moldy building microbes. Am J Respir Crit Care Med 160:1943–1946 [CrossRef]
     [Google Scholar]
  14. Jones B. L., McLintock L. A. 2003; Impact of diagnostic markers on early antifungal therapy. Curr Opin Infect Dis 16:521–526 [CrossRef]
     [Google Scholar]
  15. Kauffmann-Lacroix C., Rodier M., Jacquemin J., Goujon J., Klossek J. 2001; Detection of galactomannan for diagnosis of fungal rhinosinusitis. J Clin Microbiol 39:4593–4594 [CrossRef]
     [Google Scholar]
  16. Kim S. T., Choi J. H., Jeon H. G., Cha H. E., Hwang Y. J., Chung Y. S. 2005; Comparison between polymerase chain reaction and fungal culture for the detection of fungi in patients with chronic sinusitis and normal controls. Acta Otolaryngol 125:72–75 [CrossRef]
     [Google Scholar]
  17. Mennink-Kersten M. A., Donnelly J. P., Verweij P. E. 2004; Detection of circulating galactomannan for the diagnosis and management of invasive aspergillosis. Lancet Infect Dis 4:349–357 [CrossRef]
     [Google Scholar]
  18. Murashige N., Kami M., Kishi Y., Fujisaki G., Tanosaki R. 2005; False-positive results of Aspergillus enzyme-linked immunosorbent assays for a patient with gastrointestinal graft-versus-host disease taking a nutrient containing soybean protein. Clin Infect Dis 40:333–334
     [Google Scholar]
  19. Musher B., Fredricks D., Leisenring W., Balajee A., Smith C., Marr K. 2004; Aspergillus galactomannan enzyme immunoassay and quantitative PCR for diagnosis of invasive aspergillosis with bronchoalveolar lavage fluid. J Clin Microbiol 42:5517–5522 [CrossRef]
     [Google Scholar]
  20. Polzehl D., Weschta M., Podbielski A., Riechelmann H., Rimek D. 2005; Fungus culture and PCR in nasal lavage samples of patients with chronic rhinosinusitis. J Med Microbiol 54:31–37 [CrossRef]
     [Google Scholar]
  21. Ponikau J. U., Sherris D. A., Kern E. B., Homburger H. A., Frigas E., Gaffey T. A., Roberts G. D. 1999; The diagnosis and incidence of allergic fungal sinusitis. Mayo Clin Proc 74:877–884 [CrossRef]
     [Google Scholar]
  22. Rantakokko-Jalava K., Nikkari S., Jalava J., Eerola E., Skurnik M., Meurman O., Ruuskanen O., Alanen A., Kotilainen E. other authors 2000; Direct amplification of rRNA genes in diagnosis of bacterial infections. J Clin Microbiol 38:32–39
     [Google Scholar]
  23. Rantakokko-Jalava K., Laaksonen S., Issakainen J., Vauras J., Nikoskelainen J., Viljanen M., Salonen J. 2003; Semiquantitative detection by real-time PCR of Aspergillus fumigatus in bronchoalveolar lavage fluids and tissue biopsy specimens from patients with invasive aspergillosis. J Clin Microbiol 41:4304–4311 [CrossRef]
     [Google Scholar]
  24. Vennewald I., Henker M., Klemm E., Seebacher C. 1999; Fungal colonization of the paranasal sinuses. Mycoses 42:33–36 [CrossRef]
     [Google Scholar]
  25. Weisser M., Rausch C., Droll A., Simcock M., Sendi P., Steffen I., Buitrago C., Sonnet S., Gratwohl A. other authors 2005; Galactomannan does not precede major signs on a pulmonary computerized tomographic scan suggestive of invasive aspergillosis in patients with hematological malignancies. Clin Infect Dis 41:1143–1149 [CrossRef]
     [Google Scholar]
  26. Willinger B., Obradovic A., Selitsch B., Beck-Mannagetta J., Buzina W., Braun H., Apfalter P., Hirschl A. M., Makristathis A., Rotter M. 2003; Detection and identification of fungi from fungus balls of the maxillary sinus by molecular techniques. J Clin Microbiol 41:581–585 [CrossRef]
     [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.47101-0
Loading
Negative impact of Aspergillus galactomannan and DNA detection in the diagnosis of fungal rhinosinusitis
J. Med. Microbiol. 56, 1322 (2007); https://doi.org/10.1099/jmm.0.47101-0
/content/journal/jmm/10.1099/jmm.0.47101-0
/content/journal/jmm/10.1099/jmm.0.47101-0
Loading

Data & Media loading...

Most cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error