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https://doi.org/10.14300/mnnc.2019.14080

Differential diagnostics of noninvasive mycosis of paranasal sinuses: fungal or bacterial ball?

[Otorhinolaryngology]
Natalia Boiko; Vasiliy Mironov; Sergey Bannikov;

The aim of this research was to analyze the contents of the paranasal sinuses in 168 patients with a clinical diagnosis of «fungal ball» who had undergone endonasal endoscopic surgical intervention. The pathological content of paranasal sinuses was subjected to microscopic, microbiological and histopathological examination. The presence of fungi was confirmed in 148 of 168 patients. In 20 cases, the presence of fungi in the caseous masses, obtained during the operation, was not revealed either by microscopic, or by culture, or by histological examination, and in 19 patients bacterial microflora was detected in diagnostically significant titers, most often Bacteroides spp – in 5 patients, Staphylococcus – in 5 patients, Pseudomonas aeruginosa – in 3 patients, 2 cases of Klebsiella pneumoniae and 2 – Actinomyces spp. The above bacteria have an increased ability to form biofilms. To characterize such finds, the term «bacterial ball» is used, by analogy with the «fungal ball», denoting the fungal body of the paranasal sinuses.

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Keywords: paranasal sinuses, fungal ball, differential diagnostics