| Popis: |
Chronic rhinosinusitis (CRS) is a disease very frequently encountered by otorhinolaryngologists. According to Ponikau et al. fungi are accused to trigger eosinophilic CRS. Other authors quote fungi to cause CRS in only upto 10%. In Germany, data concerning fungal rhinosinusitis in CRS patients are rare. Therefore, a study on 51 patients with CRS and 10 controls was conducted. Nasal mucus was collected by cotton sponges (group A, n = 39) or by flushing the nose (group B, n = 12), the controls were treated respectively. Nasal secretions were processed for microbiology, fungal cultivation and cytology. Fungi and eosinophiles were visualised by microscopic study of smears in Pappenheim and Grocott. Skin prick tests and specific IgE measurements were done to evaluate an atopy. Five (12%) patients in group A and 1 patient (8%) in group B had positive fungal cultures. Altogether, from 6 (12%) patients with CRS and 2 controls fungi were cultivated. The species identified were Aspergillus, Alternaria, Aureobasidium, Candida, Cladosporium, Penicillium. Fourteen (36%) patients in group A and 2 (16%) in group B showed fungi on microscopic examination. So, in 16 (31%) patients with CRS fungi were found in the cytological preparations, 1 control was positive. In 3 patients, skin prick tests and specific antigen against fungi correlated with the microscopic and mycological findings. Our data indicate that allergic fungal rhinosinusitis can occur in 6% of CRS. In 31% of CRS fungi were found in nasal mucus. If in such patients conventional treatment fails, new therapeutic strategies could be of relevance. |
